From the Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, New York, NY (Dr. Sheridan, Dr. Pang, Dr. Page, Greenstein, Dr. Rozbruch, and Dr. Fragomen), and the Serviço de Ortopedia e Traumatologia, Hospital Governador Celso Ramos, Florianópolis, Brazil (Dr. Cardoso and Dr. Amorim).
J Am Acad Orthop Surg Glob Res Rev. 2023 Aug 3;7(8). doi: 10.5435/JAAOSGlobal-D-23-00033. eCollection 2023 Aug 1.
Bone defects may be managed with bone transport or acute shortening and lengthening using circular external fixation devices. We performed a multicenter retrospective cohort study to compare the outcomes between the Ilizarov frames and hexapod frames for the management of bone defects.
Patients treated for bone defects using either Ilizarov or hexapod frames were included for analysis in two specialist institutions. Primary outcomes were time to consolidation, bone healing index (BHI), and external fixator index (EFI). Radiographic parameters included the medial proximal tibial angle, lateral distal tibial angle, posterior proximal tibial angle, and anterior distal tibial angle.
There were 137 hexapods and 90 Ilizarov frames in total. The mean time to follow-up was 3.7 years in the hexapod group and 4.0 years in the Ilizarov group. Hexapods had a significantly lower time to consolidation (253 days versus 449 days) (P < 0.0001) and BHI (59.1 days/cm versus 87.5 days/cm) (P < 0.0001). Hexapods had a significantly better EFI (72.3 days/cm versus 96.1 days/cm) (P = 0.0009).
Hexapods may confer a significant advantage over Ilizarov frames in the management of bone defects. Time to consolidation, radiographic parameters, BHI, and EFI are all superior in hexapods.
骨缺损可以通过骨搬运或使用环形外固定器进行急性短缩和延长来治疗。我们进行了一项多中心回顾性队列研究，比较了伊利扎罗夫框架和六足架在骨缺损治疗中的效果。
在两个专业机构中，对使用伊利扎罗夫或六足架治疗骨缺损的患者进行了分析。主要结局是骨愈合时间、骨愈合指数（BHI）和外固定器指数（EFI）。影像学参数包括内侧胫骨近端角、外侧胫骨远端角、胫骨近端后角和胫骨远端前角。
共有 137 个六足架和 90 个伊利扎罗夫框架。六足架组的平均随访时间为 3.7 年，伊利扎罗夫组为 4.0 年。六足架的骨愈合时间（253 天对 449 天）（P < 0.0001）和 BHI（59.1 天/cm 对 87.5 天/cm）（P < 0.0001）显著降低。六足架的 EFI（72.3 天/cm 对 96.1 天/cm）显著更好（P = 0.0009）。
六足架在骨缺损的治疗中可能比伊利扎罗夫框架具有显著优势。骨愈合时间、影像学参数、BHI 和 EFI 均优于六足架。
