Unité de traumatologie du Centre Medico-Chirurgical (CMCA) de référence et les unités médicales des Armées (UMA), Conakry, Guinea.
Service de chirurgie orthopédique, traumatologique et reconstructrice des membres, HIA Percy, 101, avenue Henri Barbusse, 92140 Clamart, France.
Orthop Traumatol Surg Res. 2022 Nov;108(7):103377. doi: 10.1016/j.otsr.2022.103377. Epub 2022 Jul 27.
The authors analyzed results over a 7-year period for a locally manufactured external fixation and traction device (EFTD) used in tibial fracture. Three models were used, depending on the medical and technological context of the healthcare structure in question. The aim of the present study was to reports results for tibial fracture treated by EFTD in low-resource settings.
A multicenter observational study was conducted for the period 2008-2015 in a series of 34 tibial fractures (22 right, 12 left, with 1 bilateral) in 33 young adults (28 male, 5 female; mean age, 42.2 years). Nineteen were closed fractures and 15 open. The 11 recent open fractures comprised 2 Cauchoix-Duparc type I, 3 type II and 6 type III; the 4 older open fractures were infected. Four patients were lost to follow-up.
Seventeen of the patients with closed fracture had very good results, in 75% (6/8) of shaft fractures and 55.55% (5/9) of complex metaphyseal-epiphyseal fractures. In infected fractures older than 48h, there were good results in 25% of cases. In recent open fractures, there were 100% (2/2), 66.6% (2/3) and 20% (1/5) good results for types I, II and III respectively. Five patients showed malunion, well-tolerated functionally. Mean time to bone healing was 16 weeks (range, 12-72 weeks).
In developing countries, the pitfall in treating open fractures is delayed surgery due to patients' socioeconomic situation and to underequipment. The EFTD is a promising technique, readily available at low cost, easy to implement and with minimal iatrogenesis.
IV, prospective observational study.
作者分析了一种局部制造的外固定和牵引装置（EFTD）在胫骨骨折治疗中 7 年的结果。根据所涉及医疗结构的医疗和技术背景，使用了三种模型。本研究旨在报告在资源匮乏环境下使用 EFTD 治疗胫骨骨折的结果。
在 2008 年至 2015 年期间，进行了一项多中心观察性研究，共纳入 33 名年轻患者（28 名男性，5 名女性；平均年龄 42.2 岁）的 34 例胫骨骨折（22 例右侧，12 例左侧，1 例双侧）。19 例为闭合性骨折，15 例为开放性骨折。11 例近期开放性骨折中，2 例为 Cauchoix-Duparc Ⅰ型，3 例为Ⅱ型，6 例为Ⅲ型；4 例陈旧开放性骨折为感染性骨折。4 例患者失访。
17 例闭合性骨折患者中，8 例骨干骨折和 9 例复杂干骺端-骨骺骨折的优良率为 75%（6/8）和 55.55%（5/9）。48 小时以上感染性骨折的优良率为 25%。近期开放性骨折中，Ⅰ型、Ⅱ型和Ⅲ型的优良率分别为 100%（2/2）、66.67%（2/3）和 20%（1/5）。5 例患者出现畸形愈合，但功能上可耐受。骨愈合的平均时间为 16 周（范围 12-72 周）。
在发展中国家，由于患者的社会经济状况和设备不足，开放性骨折治疗的陷阱是延迟手术。EFTD 是一种很有前途的技术，成本低，易于实施，且医源性损伤最小。
IV 级，前瞻性观察性研究。
