Ge Qihang, Wan Chunyou, Shao Xing, Zhang Tao, Jia Peng, Mei Xiaolong, Wang Mingjie, Zhao Yuanhang, Pan Qingsong, Ma Jihai
Graduate School of 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. 2019 Feb 15;33(2):144-148. doi: 10.7507/1002-1892.201807008.
To explore the effectiveness of Taylor spatial frame (TSF) in the treatment of tibiofibular fractures and computer-assisted closed reduction.
The clinical data of 30 cases of tibiofibular fractures with soft tissue injury treated with TSF between January 2015 and September 2017 was retrospectively analyzed. According to different reduction methods, the patients were divided into control group (15 cases, open reduction in TSF external fixation) and trial group (15 cases, closed reduction in 1-3 days after TSF external fixation). There was no significant difference in the general data such as gender, age, affected side, cause of injury, AO classification of fracture, time from injury to operation between the two groups ( >0.05). The operation time, intraoperative blood loss, fracture healing time, and removal time of external fixator were recorded and compared between the two groups. At 3 months after removal of external fixator, the limb function was evaluated according to Johner-Wruhs criteria for evaluating the final effect of tibial shaft fracture treatment.
Both groups were followed up 9-16 months, with an average of 14 months. The operation time, intraoperative blood loss, fracture healing time, and removal time of external fixator in the trial group were significantly shorter than those in the control group ( <0.05). There were 2 cases of superficial infection of the external fixation (1 case in each group), 1 case of incision infection (control group), 1 case of delayed fracture healing (control group), 2 cases of traumatic arthritis (1 case in each group); no significant difference was found in the incidence of complications between the two groups ( =0.370, =0.543). The wounds of soft tissue defect healed by the first intension in both groups. At 3 months after removal of the external fixator, the limb function results in the trial group were excellent in 3 cases, good in 9 cases, fair in 2 cases, and poor in 1 case, and the excellent and good rate was 80.0%; in the control group, the results were excellent in 3 cases, good in 8 cases, fair in 3 cases, and poor in 1 case, and the excellent and good rate was 73.3%. There was no significant difference in incidence of complication between the two groups ( =0.917, =0.821).
Compared with intraoperative open reduction, postoperative computer-aided closed reduction can shorten the operation time, reduce the intraoperative blood loss, reduce the risk of long-term operation, avoid to destroy the blood supply of fracture end, shorten the healing time of fracture and the wearing time of stent, and alleviate the pain of patients after TSF treatment of tibiofibular fracture.
探讨泰勒空间框架（TSF）在胫腓骨骨折治疗及计算机辅助闭合复位中的有效性。
回顾性分析2015年1月至2017年9月采用TSF治疗的30例伴有软组织损伤的胫腓骨骨折患者的临床资料。根据复位方法不同，将患者分为对照组（15例，TSF外固定下切开复位）和试验组（15例，TSF外固定后1 - 3天内闭合复位）。两组患者在性别、年龄、患侧、受伤原因、骨折AO分型、受伤至手术时间等一般资料方面比较，差异无统计学意义（>0.05）。记录并比较两组患者的手术时间、术中出血量、骨折愈合时间及外固定架拆除时间。外固定架拆除后3个月，根据Johner-Wruhs胫骨干骨折治疗最终效果评价标准对肢体功能进行评估。
两组均随访9 - 16个月，平均14个月。试验组患者的手术时间、术中出血量、骨折愈合时间及外固定架拆除时间均明显短于对照组（<0.05）。外固定浅表感染2例（每组1例），切口感染1例（对照组），骨折延迟愈合1例（对照组），创伤性关节炎2例（每组1例）；两组并发症发生率比较，差异无统计学意义（=0.370，=0.543）。两组软组织缺损创面均一期愈合。外固定架拆除后3个月，试验组肢体功能结果：优3例，良9例，可2例，差1例，优良率为80.0%；对照组结果：优3例，良8例，可3例，差1例，优良率为73.3%。两组并发症发生率比较，差异无统计学意义（=0.917，=0.821）。
与术中切开复位相比，术后计算机辅助闭合复位可缩短手术时间，减少术中出血量，降低长时间手术风险，避免破坏骨折端血供，缩短骨折愈合时间及支架佩戴时间，减轻TSF治疗胫腓骨骨折患者术后疼痛。
