Ge Qihang, Wan Chunyou, Liu Yabei, Ji Xu, Ma Jihai, Cao Haikun, Yong Wei, Liu Zhao, Zhang Ningning
Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, P.R.China.
Department of Trauma Orthopedics, Tianjin Hospital, Tianjin, 300211,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Aug 15;31(8):931-935. doi: 10.7507/1002-1892.201703072.
To investigate the effect of axial stress stimulation on tibial and fibular open fractures healing after Taylor space stent fixation.
The data of 45 cases with tibial and fibular open fractures treated by Taylor space stent fixation who meet the selection criteria between January 2015 and June 2016 were retrospectively analysed. The patients were divided into trial group (23 cases) and control group (22 cases) according to whether the axial stress stimulation was performed after operation. There was no significant difference in gender, age, affected side, cause of injury, type of fracture, and interval time from injury to operation between 2 groups ( >0.05). The axial stress stimulation was performed in trial group after operation. The axial load sharing ratio was tested, and when the value was less than 10%, the external fixator was removed. The fracture healing time, full weight-bearing time, and external fixator removal time were recorded and compared. After 6 months of external fixator removal, the function of the limb was assessed by Johner-Wruhs criteria for evaluation of final effectiveness of treatment of tibial shaft fractures.
There were 2 and 3 cases of needle foreign body reaction in trial group and control group, respectively, and healed after symptomatic anti allergic treatment. All the patients were followed up 8-12 months with an average of 10 months. All the fractures reached clinical healing, no complication such as delayed union, nonunion, or osteomyelitis occurred. The fracture healing time, full weight-bearing time, and external fixator removal time in trial group were significantly shorter than those in control group ( <0.05). After 6 months of external fixator removal, the function of the limb was excellent in 13 cases, good in 6 cases, fair in 3 cases, and poor in 1 case in trial group, with an excellent and good rate of 82.6%; and was excellent in 5 cases, good in 10 cases, fair in 4 cases, and poor in 3 cases in control group, with an excellent and good rate of 68.2%, showing significant difference between 2 groups ( =-2.146, =0.032).
The axial stress stimulation of Taylor space stent fixation can promote the healing of tibial and fibular open fractures and promote local bone formation at fracture site.
探讨轴向应力刺激对Taylor空间支架固定后胫腓骨开放性骨折愈合的影响。
回顾性分析2015年1月至2016年6月间45例符合入选标准的采用Taylor空间支架固定治疗的胫腓骨开放性骨折患者资料。根据术后是否进行轴向应力刺激将患者分为试验组（23例）和对照组（22例）。两组患者在性别、年龄、患侧、受伤原因、骨折类型以及受伤至手术间隔时间等方面比较，差异均无统计学意义（>0.05）。试验组术后进行轴向应力刺激，检测轴向负荷分担率，当该值小于10%时拆除外固定架。记录并比较骨折愈合时间、完全负重时间及外固定架拆除时间。外固定架拆除6个月后，采用Johner-Wruhs胫骨干骨折治疗最终疗效评价标准评估患肢功能。
试验组和对照组分别有2例和3例出现针道异物反应，经对症抗过敏治疗后愈合。所有患者均获随访8～12个月，平均10个月。所有骨折均达临床愈合，未出现延迟愈合、不愈合或骨髓炎等并发症。试验组骨折愈合时间、完全负重时间及外固定架拆除时间均明显短于对照组（<0.05）。外固定架拆除6个月后，试验组患肢功能优13例，良6例，可3例，差1例，优良率为82.6%；对照组优5例，良10例，可4例，差3例，优良率为68.2%，两组比较差异有统计学意义（=-2.146，=0.032）。
Taylor空间支架固定下的轴向应力刺激可促进胫腓骨开放性骨折愈合，促进骨折部位局部骨形成。
