Department of Trauma and Microreconstructive surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
Department of Orthopaedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
BMC Musculoskelet Disord. 2022 Mar 8;23(1):224. doi: 10.1186/s12891-022-05172-5.
When the reduction of long bone shaft fracture fragments is performed by a hexapod external fixator, the collision and interference between bony ends often results in an incomplete reduction and a time-consuming procedure. The purpose of this study was to present and determine the clinical effectiveness of staged correction trajectory with hexapod external fixator in the reduction of a long bone shaft fracture.
A total of 57 patients with tibial shaft fractures treated by hexapod external fixator were retrospectively analyzed from June 2016 to February 2020. Thirty-one cases (Group I) underwent a conventional one-step reduction trajectory from June 2016 to July 2018. Starting in September 2018, the other twenty-six patients (Group II) underwent staged correction trajectory (three key points reduction trajectory of "distraction-derotation-reduction"). The demographic data, residual deformities before and after correction, number of repeated X-rays after the first postoperative X-ray, duration of deformity correction process, and external fixation time were analyzed. Johner-Wruhs criteria were used to evaluate the final clinical outcomes.
All the 57 patients achieved satisfactory fracture reduction and bone union. There were no significant differences between the two groups in demographic data, residual deformities before and after correction, external fixation time, and final clinical outcomes (p > 0.05). The average number of repeated X-rays after the first postoperative X-ray and mean duration of deformity correction process in Group II (1.3 times, 2.9 days) were all less than those in Group I (2.3 times, 5.1 days) (p < 0.05).
Compared with the conventional one-step reduction trajectory, there is no differences in final clinical outcomes, but the staged correction trajectory provides less repeated X-rays and shorter reduction process duration.
当使用六足外固定架对长骨骨干骨折碎片进行复位时，骨端之间的碰撞和干扰常常导致复位不完全，且过程耗时。本研究旨在介绍和确定六足外固定架分步矫正轨迹在长骨干骨折复位中的临床效果。
回顾性分析 2016 年 6 月至 2020 年 2 月期间采用六足外固定架治疗的 57 例胫骨骨干骨折患者。31 例（I 组）采用传统的一步法复位轨迹，2018 年 6 月至 2018 年 7 月。自 2018 年 9 月起，另外 26 例患者（II 组）采用分步矫正轨迹（“牵开-旋转移位-复位”三点复位轨迹）。分析患者的一般资料、矫正前后的残余畸形、首次术后 X 线片后重复 X 线片的数量、畸形矫正过程的持续时间和外固定时间。采用 Johner-Wruhs 标准评估最终临床结果。
所有 57 例患者均获得满意的骨折复位和骨愈合。两组患者的一般资料、矫正前后的残余畸形、外固定时间和最终临床结果差异均无统计学意义（p>0.05）。II 组首次术后 X 线片后重复 X 线片的平均次数（1.3 次）和畸形矫正过程的平均持续时间（2.9 天）均少于 I 组（2.3 次，5.1 天）（p<0.05）。
与传统的一步复位轨迹相比，最终临床结果无差异，但分步矫正轨迹可减少重复 X 线片的次数，缩短复位过程的持续时间。
