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[泰勒空间框架与单侧外固定器治疗胫腓骨开放性骨折的对比研究]

[A comparative study of Taylor spatial frame and unilateral external fixator in treatment of tibiofibular open fractures].

作者信息

Ma He, Yao Hui, Zhang Tao, Wan Chunyou

机构信息

Department of Limb Orthopedics, Tianjin Hospital, Tianjin, 300211, P.R.China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Apr 15;34(4):447-451. doi: 10.7507/1002-1892.201909120.

Abstract

OBJECTIVE

To compare the effectiveness of Taylor spatial frame (TSF) and unilateral external fixator in the treatment of tibiofibular open fractures.

METHODS

Between January 2016 and July 2018, 74 patients with tibiofibular open fracture who met the selection criteria were divided into TSF group (43 cases, fixed with TSF) and unilateral group (31 cases, fixed with unilateral external fixator) according to the principle of entering the group every other day. There was no significant difference in gender, age, affected side, cause of injury, type of fracture between the two groups ( >0.05). The operation time, fracture healing time, removal time of external fixator, and complications were recorded and compared between the two groups. The limb function was evaluated according to Johner-Wruhs criteria for evaluating the final effectiveness of tibial shaft fracture treatment. The recovery of lower limb force line was ecaluated by LUO Congfeng . criteria.

RESULTS

All patients were followed up 8-22 months, with a median of 12 months. All fractures healed, and no complication such as delayed union, nonunion, or osteomyelitis occurred. The operation time, fracture healing time, and removal time of external fixator in TSF group were significantly shorter than those in unilateral group ( <0.05). At 3 months after the removal of the external fixator, the limb function was evaluated according to the Johner-Wruhs standard. In TSF group, 41 cases were excellent, 1 case was good, and 1 case was fair, and the excellent and good rate was 97.67%; in unilateral group, 30 cases were excellent and 1 case was fair, and the excellent and good rate was 96.77%; there was no significant difference between the two groups ( =0.666). At 4 months after operation, the recovery of lower limb force line was ecaluated by LUO Congfeng . criterion. In TSF group, 41 cases were excellent, 2 cases were good, and 1 case was fair, and the excellent and good rate was 97.67%; in unilateral group, 29 cases were excellent, 1 case was good, 1 case was fair, and the excellent and good rate was 96.77%; there was no significant difference between the two groups ( =0.666).

CONCLUSION

For tibiofibular open fracture, on the premise of fracture healing, TSF technology is superior to unilateral external fixation in terms of shortening operation time, fracture healing time, and removal time of external fixator.

摘要

目的

比较泰勒空间框架(TSF)与单侧外固定架治疗胫腓骨开放性骨折的疗效。

方法

2016年1月至2018年7月,将74例符合入选标准的胫腓骨开放性骨折患者按隔日入组原则分为TSF组(43例,采用TSF固定)和单侧组(31例,采用单侧外固定架固定)。两组患者在性别、年龄、患侧、受伤原因、骨折类型方面差异无统计学意义(P>0.05)。记录并比较两组患者的手术时间、骨折愈合时间、外固定架拆除时间及并发症情况。根据Johner-Wruhs标准评估胫骨骨折治疗最终疗效的肢体功能。采用罗从风标准评估下肢力线恢复情况。

结果

所有患者均获随访8~22个月,中位随访时间12个月。所有骨折均愈合,未发生延迟愈合、不愈合或骨髓炎等并发症。TSF组的手术时间、骨折愈合时间及外固定架拆除时间均明显短于单侧组(P<0.05)。外固定架拆除后3个月,根据Johner-Wruhs标准评估肢体功能。TSF组优41例,良1例,可1例,优良率为97.67%;单侧组优30例,可1例,优良率为96.77%;两组比较差异无统计学意义(P=0.666)。术后4个月,采用罗从风标准评估下肢力线恢复情况。TSF组优41例,良2例,可1例,优良率为97.67%;单侧组优29例,良1例,可1例,优良率为96.77%;两组比较差异无统计学意义(P=0.666)。

结论

对于胫腓骨开放性骨折,在骨折愈合的前提下,TSF技术在缩短手术时间、骨折愈合时间及外固定架拆除时间方面优于单侧外固定架。

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