Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa.
Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa.
Injury. 2022 Oct;53(10):3525-3529. doi: 10.1016/j.injury.2022.07.034. Epub 2022 Jul 22.
Temporary spanning fixation aims to provide bony stability whilst allowing access and resuscitation of the traumatised soft-tissue envelope. Conventional monolateral fixators are prone to half-pin morbidity in feet, variation in construct stability and limited weight-bearing potential. This study compares traditional delta-frame monolateral external fixators to ankle spanning circular fixators.
Two cohorts were matched for demographics and fracture patterns. The quality of initial reduction and the maintenance of reduction until definitive surgery was assessed by two authors and categorised into four domains. Secondary measures included fixator costs, time to definitive surgery and complications.
Fifty-five delta-frames and 51 circular fixators were statistically matched for demographics and fracture pattern. "Excellent" and "Good" initial reduction was achieved in 50 (91%) delta-frames and 51 (100%) circular fixators (p = 0.027). Deterioration of initial reduction quality was seen in 12 (22%) delta-frames and two (4%) circular fixators (p < 0.001). Post-fixator dislocation occurred in five (9%) delta-frames and one (2%) circular fixator (p = 0.147). Median duration in spanned fixation was 11 days in both groups (p = 0.114). Three (5%) delta-frames and 13 (25%) circular fixators were used as definitive fixation. The mean implant cost was 4,307 USD for delta-frames and 3747 USD for circular fixators.
Temporary spanning circular fixation offers superior intra-operative reduction and maintenance of reduction and provides more opportunity to be used as definitive fixation. Circular fixation implants also proved to be less expensive and protected against further scheduled or unscheduled returns to theatre.
IV, retrospective cohort study.
临时跨距固定旨在提供骨稳定性，同时允许对受伤的软组织进行处理和复苏。传统的单侧固定器容易在脚部出现半钉并发症，结构稳定性变化和有限的承重潜力。本研究比较了传统的 delta 框架单侧外固定器和踝关节跨距环式固定器。
根据人口统计学和骨折模式将两个队列进行匹配。两位作者评估了初始复位质量和直至确定性手术的复位维持情况，并将其分为四个领域。次要指标包括固定器费用、确定性手术时间和并发症。
在人口统计学和骨折模式方面，55 个 delta 框架和 51 个环形固定器在统计学上匹配。50 个（91%）delta 框架和 51 个（100%）环形固定器达到了“优秀”和“良好”的初始复位（p=0.027）。12 个（22%）delta 框架和 2 个（4%）环形固定器的初始复位质量恶化（p<0.001）。5 个（9%）delta 框架和 1 个（2%）环形固定器发生了固定器脱位（p=0.147）。两组跨距固定的中位固定时间均为 11 天（p=0.114）。3 个（5%）delta 框架和 13 个（25%）环形固定器作为确定性固定。delta 框架的平均植入物费用为 4307 美元，环形固定器为 3747 美元。
临时跨距环形固定可提供更好的术中复位和复位维持，并提供更多机会作为确定性固定。环形固定器植入物也被证明更便宜，并能防止进一步计划或非计划返回手术室。
IV，回顾性队列研究。
