Clinical School of Orthopedics, Tianjin Medical University, Tianjin, China.
Department of Orthopedic Traumatology, Tianjin Hospital, Tianjin, China.
Orthop Surg. 2024 Sep;16(9):2157-2166. doi: 10.1111/os.14192. Epub 2024 Aug 6.
Bone transport has become the gold standard for treating large segmental tibial bone defects. The technique for application the Ilizarov circular fixator (ICF) has a long learning curve and is associated with many complications. There are few clinical studies on bone transport via the Taylor spatial frame (TSF). The main purpose of this study was to compare the radiological and clinical and outcomes of bone transport by using the TSF and the ICF.
There were 62 patients included in this retrospective study from June 2011 to June 2021 and distributed to two groups according to the fixation method: a TSF group consisting of 30 patients and an ICF group consisting of 32 patients. Demographic information, surgical duration, external fixation times, external fixation index, final radiographic results, complications, and clinical outcomes were recorded and examined. The clinical outcomes were assessed using the ASAMI criteria during the most recent clinical visit. Then, statistical analysis such as independent-samples t tests or chi-Square test was performed.
The mean surgical duration in the TSF group was 93.8 ± 7.3 min, which was shorter than that in the ICF group (109.8 ± 1.4 min) (p < 0.05). Compared to the ICF group (10.2 ± 2.0 months), the TSF group (9.7 ± 1.8 months) had a shorter average external fixation time (p > 0.05). The external fixation index was 1.4 ± 0.2 m/cm and 1.5 ± 0.1 m/cm in the two groups. Moreover, there was no significant difference between the two groups. At the last follow-up visit, the medial proximal tibial angle (MPTA) and posterior proximal tibial angle (PPTA) in the TSF group were 88.1 ± 12.1° and 80.9 ± 1.3°, respectively. The MPTA and PPTA in the ICF group were 84.4 ± 2.4° and 76.2 ± 1.9°, respectively. There were statistically significant differences between the two groups (all p < 0.05). The complication rate was 50% in the TSF group and 75% in the ICF group. Moreover, the ASAMI score between the two groups was no statistically significant difference (p > 0.05).
No statistically significant difference was found in clinical outcomes between the use of Taylor spatial frame and Ilizarov circular fixator for treating large segmental tibial bone defects. However, TSF is a shorter and simpler procedure that causes fewer complications and improves limb alignment.
骨搬运已成为治疗大段胫骨骨缺损的金标准。应用伊利扎洛夫环形外固定架（ICF）的技术有很长的学习曲线，并与许多并发症有关。关于泰勒空间框架（TSF）的骨搬运的临床研究很少。本研究的主要目的是比较 TSF 和 ICF 治疗大段胫骨骨缺损的影像学和临床结果。
本回顾性研究共纳入 62 例患者，时间为 2011 年 6 月至 2021 年 6 月，根据固定方法分为两组：TSF 组 30 例，ICF 组 32 例。记录并检查了患者的一般资料、手术时间、外固定时间、外固定指数、最终影像学结果、并发症和临床结果。在最近的临床随访中，使用 ASAMI 标准评估临床结果。然后进行独立样本 t 检验或卡方检验等统计分析。
TSF 组的平均手术时间为 93.8±7.3min，短于 ICF 组的 109.8±1.4min（p<0.05）。与 ICF 组（10.2±2.0 个月）相比，TSF 组（9.7±1.8 个月）的平均外固定时间更短（p>0.05）。两组的外固定指数分别为 1.4±0.2m/cm 和 1.5±0.1m/cm，差异无统计学意义。末次随访时，TSF 组的内侧近端胫骨角（MPTA）和后侧近端胫骨角（PPTA）分别为 88.1±12.1°和 80.9±1.3°，ICF 组分别为 84.4±2.4°和 76.2±1.9°，两组比较差异有统计学意义（均 p<0.05）。TSF 组并发症发生率为 50%，ICF 组为 75%，两组比较差异无统计学意义（p>0.05）。两组 ASAMI 评分比较差异无统计学意义（p>0.05）。
Taylor 空间框架和伊利扎洛夫环形外固定架治疗大段胫骨骨缺损的临床结果无统计学差异。然而，TSF 是一种更短、更简单的手术，并发症更少，可改善肢体对线。
