Messner Juergen, Chhina Harpreet, Davidson Sophia, Abad Jero, Cooper Anthony
Department of Orthopaedic Surgery, BC Children's Hospital Vancouver, Canada.
Royal Hospital for Sick Children, Edinburgh, UK.
J Child Orthop. 2021 Apr 19;15(2):114-121. doi: 10.1302/1863-2548.15.200165.
Comparison of two hexapod frame systems in paediatric tibial deformity correction; the Taylor Spatial Frame (TSF) and Orthex Hexapod System.
Paediatric patients with congenital and acquired tibial deformities treated with either TSF (between 2014 and 2016) or Orthex (between 2017 and 2019) frames were included in a retrospective comparative study. Outcome measures were healing index, pin infection rate, regenerate quality and density, software residual rate, deformity correction accuracy, strut exchanges and quality of life (QoL).
The TSF group had 17 patients (18 frames) and the Orthex group had 21 patients (25 frames). The most common indications for tibial deformity correction were fibular hemimelia (14) and septic or traumatic growth arrest (8). The median time in frame was 230 days (TSF) 203 days (Orthex) (p= 0.06). The mean lengthening achieved was 54 mm (TSF) and 51 mm (Orthex) (p = 0.41). The healing index was 41 days/cm (TSF) 43 days/cm (Orthex) (p = 0.70). Pin site infections occurred more in the TSF cohort (40%) than in the Orthex cohort (18%) (p < 0.001). The regenerate in the Orthex group showed higher density at three months (p = 0.029) and was more homogenous (p = 0.023) at six months after frame application. Strut exchanges were less frequent with the Orthex system (p < 0.0001). QoL measures were similar in both cohorts (p = 0.92).
This is the first study to compare two hexapod designs in paediatric orthopaedics. The Orthex system showed superiority in regenerate quality and a significant reduction in pin site infection rates. Both systems delivered predictable and accurate limb deformity correction.
III.
比较两种用于小儿胫骨畸形矫正的六足框架系统，即泰勒空间框架（TSF）和奥泰克斯六足系统。
本回顾性比较研究纳入了2014年至2016年期间使用TSF框架以及2017年至2019年期间使用奥泰克斯框架治疗的先天性和后天性胫骨畸形患儿。观察指标包括愈合指数、钢针感染率、再生质量和密度、软件残留率、畸形矫正精度、支撑杆更换情况以及生活质量（QoL）。
TSF组有17例患者（18个框架），奥泰克斯组有21例患者（25个框架）。胫骨畸形矫正最常见的适应证是腓骨半肢畸形（14例）和感染性或创伤性生长停滞（8例）。佩戴框架的中位时间为230天（TSF）和203天（奥泰克斯）（p = 0.06）。平均延长长度分别为54毫米（TSF）和51毫米（奥泰克斯）（p = 0.41）。愈合指数为41天/厘米（TSF）和43天/厘米（奥泰克斯）（p = 0.70）。TSF队列的钢针部位感染发生率（40%）高于奥泰克斯队列（18%）（p < 0.001）。奥泰克斯组的再生组织在框架应用后3个月时密度更高（p = 0.029），6个月时更均匀（p = 0.023）。奥泰克斯系统的支撑杆更换频率较低（p < 0.0001）。两个队列的生活质量指标相似（p = 0.92）。
这是第一项比较两种六足设计在小儿骨科应用的研究。奥泰克斯系统在再生质量方面表现出优势，且钢针部位感染率显著降低。两种系统都能实现可预测且准确的肢体畸形矫正。
III级
