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应用 Taylor 空间框架闭合和塑形胫骨开放性骨折软组织缺损——一种简单的技术。

Intentional deformation and closure of soft tissue defect in open tibial fractures with a taylor spatial frame--a simple technique.

机构信息

Department of Orthopaedics, King's College Hospital, Denmark Hill, London, UK.

出版信息

J Orthop Trauma. 2013 Aug;27(8):451-6. doi: 10.1097/BOT.0b013e318284727a.

Abstract

OBJECTIVES

We describe a way of using Taylor spatial frames (TSFs) for acute deformation of Gustilo IIIB tibial fractures and infected tibial nonunions to close the soft tissue defects and to gradually restore anatomical alignment. We use the Direct Scheduler Utility module of the web-based software for TSFs to successfully restore the anatomical alignment.

DESIGN

We report a case series of the above technique.

SETTING

Care was carried out at a tertiary referral center for limb reconstruction.

PATIENTS

Seven consecutive patients with significant soft tissue loss after tibial fractures were treated.

INTERVENTION

Defects were closed with acute deformation of the fracture followed by gradual correction to anatomical alignment with a 2-ring TSF.

MAIN OUTCOME MEASUREMENT

Successful closure of the soft tissue defect was our primary outcome measure.

RESULTS

Soft tissue defects ranged from 3 to 10 cm. All healed without additional plastic surgery to cover the exposed tibia. Only 1 patient required an additional TSF prescription to achieve anatomical alignment.

CONCLUSIONS

The use of the Direct Scheduler module of the web-based TSF software allows the complete correction of complex deformities without the need for obtaining complex mounting and frame parameters. We achieved successful closure of soft tissue defects and restored the anatomical tibial alignment in all our cases.

摘要

目的

我们描述了一种使用 Taylor 空间框架(TSF)治疗 Gustilo IIIB 型胫骨骨折和感染性胫骨骨不连的急性变形方法,以闭合软组织缺损并逐渐恢复解剖对线。我们使用基于网络的 TSF 的 Direct Scheduler Utility 模块成功地恢复了解剖对线。

设计

我们报告了上述技术的一系列病例。

设置

在肢体重建的三级转诊中心进行了治疗。

患者

7 例胫骨骨折后有明显软组织损失的连续患者接受了治疗。

干预

通过骨折的急性变形闭合缺损,然后使用 2 环 TSF 逐渐矫正到解剖对线。

主要观察指标

软组织缺损成功闭合是我们的主要观察指标。

结果

软组织缺损范围为 3 至 10cm。所有患者均愈合,无需额外的整形手术覆盖暴露的胫骨。仅 1 例患者需要额外的 TSF 处方以达到解剖对线。

结论

使用基于网络的 TSF 软件的 Direct Scheduler 模块允许在不需要获得复杂的安装和框架参数的情况下完全矫正复杂的畸形。我们在所有病例中都成功地闭合了软组织缺损,并恢复了解剖学上的胫骨对线。

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