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六足环状固定治疗胫骨骨干急性骨折的相关并发症:高容量创伤中心的回顾性描述性研究。

Complications associated with hexapod circular fixation for acute fractures of the tibia diaphysis: A retrospective descriptive study at a high volume trauma centre.

机构信息

Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.

Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.

出版信息

Injury. 2020 Feb;51(2):516-521. doi: 10.1016/j.injury.2019.11.012. Epub 2019 Nov 14.

DOI:10.1016/j.injury.2019.11.012
PMID:31759617
Abstract

UNLABELLED

The use of hexapod circular external fixation in acute tibia fracture care is increasing as more general orthopaedic surgeons are gaining expertise with the use of this treatment modality. Limited data is currently available on the complications that may be encountered with this treatment strategy.

AIM

To review the complications and outcomes of acute diaphyseal tibia fractures definitively treated with hexapod circular external fixation at a high volume orthopaedic trauma centre.

METHODS

Retrospective review of clinical and radiological data of adult patients with acute diaphyseal tibia fractures treated with hexapod external fixation between 2012 and 2015 at a single centre.

RESULTS

A total of 102 diaphyseal fractures were definitively treated with hexapod circular external fixation. Union was achieved in 101 cases with an average time to union of 25.6 weeks. Complications included pin site infection (56%); wound complications (19.67%); osteitis (11.76%); malunion (15.69%) and knee and ankle joint contractures (31.32%).

CONCLUSION

Hexapod circular external fixation as definitive treatment of for diaphyseal tibia fractures demonstrates an excellent union rate with acceptable time to union. Complications rates are comparable to that of all fine wire circular fixators. Malalignment in is however a concern, considering that this device enables the surgeon to achieve accurate alignment through gradual deformity correction aided by computer software.

摘要

目的

在高容量骨科创伤中心,回顾使用六足环状外固定架治疗急性骨干胫骨骨折的并发症和结果。

方法

对 2012 年至 2015 年在单一中心使用六足外固定架治疗的成人急性骨干胫骨骨折的临床和影像学数据进行回顾性分析。

结果

共 102 例骨干骨折采用六足环状外固定架确定性治疗,平均愈合时间为 25.6 周,其中 101 例愈合。并发症包括钉道感染(56%);伤口并发症(19.67%);骨髓炎(11.76%);畸形愈合(15.69%)和膝关节及踝关节挛缩(31.32%)。

结论

六足环状外固定架作为骨干胫骨骨折的确定性治疗方法,具有良好的愈合率和可接受的愈合时间。并发症发生率与所有细钢丝环状固定器相当。然而,对线不良是一个问题,因为该装置可以通过计算机软件辅助逐渐矫正畸形来实现准确的对线。

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