Mahapatra Swagat, Rengarajan Nandakumar
a Department of Orthopaedics , Mahatma Gandhi Medical College and Research Institute , Pondicherry , India.
Expert Rev Med Devices. 2017 Jan;14(1):83-85. doi: 10.1080/17434440.2017.1265886. Epub 2016 Dec 8.
Compound fractures form a bulk of Orthopaedic Trauma cases in a developing country like India. External Fixation devices are the mainstays of treatment of these open fractures. They are generally used as a one use disposable device and add a great burden to the health care costs, especially in a developing country. In our study we evaluated the efficacy and complication rate of recycled external fixators with that of new external fixators.
This was a prospective randomised interventional study conducted in a tertiary care teaching hospital of a developing country. Patients who fulfilled the inclusion criteria were entered into the trial of new vs. recycled external fixators. Outcome indicators used were pin tract infections, loss of fixation and loosening of components.
Patients were evaluated at the time of removal of fixator components for outcome indicators. Of the 95 patients in our study (49 new frames and 46 recycled frames) no significant difference was found in the incidence of pin tract infection (8.16% in new vs. 8.69% in recycled), loss of fixation (10.2% in new vs. 13.04% in recycled) and loosening of components (6.12% in new vs. 8.69% in recycled).
Around 17% of consentable patients did not want to have an external fixator system with recycled components. Our study concluded that recycling of external fixator components is safe and equally effective, with sizable cost saving.
在像印度这样的发展中国家，开放性骨折占骨科创伤病例的很大一部分。外固定装置是这些开放性骨折治疗的主要手段。它们通常作为一次性使用的装置，给医疗保健成本带来了巨大负担，尤其是在发展中国家。在我们的研究中，我们评估了回收外固定器与新型外固定器的疗效和并发症发生率。
这是一项在发展中国家的三级护理教学医院进行的前瞻性随机干预研究。符合纳入标准的患者进入新型外固定器与回收外固定器的试验。使用的结果指标包括针道感染、固定丢失和部件松动。
在拆除固定器部件时对患者进行结果指标评估。在我们研究的95名患者中（49个新型框架和46个回收框架），针道感染发生率（新型为8.16%，回收型为8.69%）、固定丢失（新型为10.2%，回收型为13.04%）和部件松动（新型为6.12%，回收型为8.69%）均未发现显著差异。
约17%的符合条件患者不希望使用带有回收部件的外固定器系统。我们的研究得出结论，外固定器部件的回收是安全且同样有效的，能节省可观的成本。
