Abstract: Objective　To compare the efficacy and safety between Masquelet technique and bone transport in lower extremity bone defect reconstruction.　Methods　PubMed, EMBASE, CNKI, Wanfang, CBM and Weipu databases were searched. Chinese and English literatures on Masquelet technique and bone transport in the treatment of lower limb bone defect published in official journals from January 1950 to October 2019 were collected. The quality of the included literatures was strictly evaluated, and relevant data were extracted. The data were statistically analyzed by RevMan 5.3 software.  Results  A total of seven studies involving 325 patients were included. There were no significant difference in Paley bone healing (RR=0.99, 95% CI:0.85,1.15, P=0.93), the rate of good and excellent limb function (RR=1.23, 95% CI: 0.90, 1.67, P=0.19), the Iowa knee score (SMD=0.45, 95% CI: -0.05, 0.94, P=0.08), and the Iowa ankle score (SMD=0.10, 95% CI: -0.39, 0.59, P=0.69) between the Masquelet group and bone transport group. Compared with the bone transport group, there was a lower incidence of complications (RR＝0.55, 95% CI: 0.38，0.79, P＝0.001), a higher infection control rate (RR=1.15, 95% CI:1.03,1.30,P=0.02), fewer surgeries (SMD=-0.47,95% CI:-0.81,-0.14,P=0.005), and a shorter healing time (SMD=-1.19, 95% CI:2.15,0.22,P=0.02), higher postoperative SF-36 score (SMD=2.33, 95% CI: 1.81, 2.85, P<0.01) in the Masquelet group.  Conclusions   Compared with bone transport technique, Masquelet technique may have more advantages in the incidence of complications, infection control rate, number of surgeries, healing time, and postoperative SF-36 score in repairing of bone defects of lower extremity. However, there is no difference in Paley bone healing score, limb function score, Iowa knee and ankle joint score. Further research is required and future studies should include assessments of outcome at long-term follow-up.

Key words: Masquelet technique, 　Bone transport, 　Bone defect, 　Meta-analysis