PGIMS, 9J28, Medical Campus, PGIMS Rohtak, Haryana, 124001, India.
Bone Joint J. 2016 Oct;98-B(10):1399-1405. doi: 10.1302/0301-620X.98B10.37946.
This is a prospective randomised study which compares the radiological and functional outcomes of ring and rail fixators in patients with an infected gap (> 3 cm) nonunion of the tibia.
Between May 2008 and February 2013, 70 patients were treated at our Institute for a posttraumatic osseocutaneous defect of the tibia measuring at least 3 cm. These were randomised into two groups of 35 patients using the lottery method. Group I patients were treated with a ring fixator and group II patients with a rail fixator. The mean age was 33.2 years (18 to 64) in group I and 29.3 years (18 to 65) in group II. The mean bone gap was 5.84 cm in group I and 5.78 cm in group II. The mean followup was 33.8 months in group I and 32.6 months in group II. Bone and functional results were assessed using the classification of the Association for the Study and Application of the Method of Ilizarov (ASAMI). Functional results were also assessed at six months using the short musculoskeletal functional assessment (SMFA) score.
The bone result was excellent, good, fair and poor in 21, 12, 0 and 2 in group I; and 14, 15, 3, and 3 in group II, respectively. The functional results were excellent, good, fair, poor and failure in 16, 17, 1, 0 and 1 in group I; and 22, 10, 0, 3 and 0 in group II, respectively. Both fixator systems achieved comparable rates of union and functional outcomes. The rate of deep pintract infection was significantly higher in the rail fixator group but patients found it more comfortable.
We recommend the use of a ring fixator in patients with a bone gap of more than 6 cm. Patients with a bone gap up to 6 cm can be managed with either a ring or rail fixator. Cite this article: Bone Joint J 2016;98B:1399-1405.
本研究为前瞻性随机对照研究，旨在比较环形和轨道固定器治疗胫骨感染性骨不连（>3cm 骨缺损）的影像学和功能结果。
2008 年 5 月至 2013 年 2 月，本研究所治疗的 70 例创伤后胫骨皮肤骨缺损患者，骨缺损长度至少 3cm，采用随机数字表法分为两组，每组 35 例。其中，采用环形固定器治疗的为组 I，采用轨道固定器治疗的为组 II。组 I 患者平均年龄 33.2 岁（18-64 岁），组 II 患者平均年龄 29.3 岁（18-65 岁）。组 I 患者平均骨缺损长度为 5.84cm，组 II 患者平均骨缺损长度为 5.78cm。组 I 患者平均随访时间为 33.8 个月，组 II 患者平均随访时间为 32.6 个月。采用伊利扎洛夫协会（ASAMI）的分类标准评估骨和功能结果。采用短节段肌肉骨骼功能评估（SMFA）评分在术后 6 个月评估功能结果。
组 I 患者中，骨愈合结果优、良、可、差分别为 21、12、0、2 例；组 II 患者中，优、良、可、差分别为 14、15、3、3 例。组 I 患者中，功能结果优、良、可、差、失败分别为 16、17、1、0、1 例；组 II 患者中，优、良、可、差分别为 22、10、0、3、0 例。两种固定器系统的愈合率和功能结果相当。轨道固定器组深部穿刺感染率显著更高，但患者感觉更舒适。
对于骨缺损>6cm 的患者，我们建议使用环形固定器。对于骨缺损长度达 6cm 以内的患者，可选择环形或轨道固定器。
请注意，这只是一个示例译文，可能存在一些不准确或不流畅的地方。具体的翻译质量需要根据实际情况进行评估和调整。
