Zhao Zhiming, Ji Guoqi, Cai Chengkuo, Shu Hengsheng, Xu Weiguo
Clinical School of Orthopedics, Tianjin Medical University, Tianjin, China.
Department of Orthopedic Traumatology, Tianjin Hospital, Tianjin, China.
Orthop Surg. 2025 Jul;17(7):1985-1994. doi: 10.1111/os.70067. Epub 2025 May 15.
The management of infectious tibial defects with concomitant soft tissue loss (ITD-STL) continues to pose substantial clinical challenges in orthopedic practice. This study aimed to compare the clinical efficacy of the Taylor Spatial Frame (TSF) versus the Monolateral External Fixator (MEF) in achieving bone and soft tissue reconstruction for ITD-STL.
A retrospective cohort study was performed on 49 consecutive patients with ITD-STL admitted between July 2010 and September 2022. The dataset included 25 patients who received treatment with the TSF, whereas 24 patients underwent treatment with the MEF. Demographic information, wound healing time, bone healing index, external fixation index, cost of hospitalization, and complications were recorded and compared between the two groups. Bone healing and functional recovery were assessed at the last follow-up (mean 18.8 months postoperatively; range 12-24 months) using the Association for the Study and Application of the Method of Ilizarov criteria (ASAMI) score. Then, statistical analysis such as independent samples t tests or chi-Square test was performed.
The wound healing time was (89.5 ± 30.6 days) in the TSF group and (86.2 ± 31.8 days) in the MEF group (p > 0.05). The bone healing index was (45.49 ± 11.99 d/cm) in the TSF group and (48.20 ± 13.01 d/cm) in the MEF group (p > 0.05). The external fixation index of the TSF group (52.4 ± 7.2 d/cm) was significantly lower than the MEF group (58.6 ± 10.3 d/cm) (p < 0.05). The total hospitalization cost was significantly higher in the TSF group compared to the MEF group (67.16 ± 2.46 thousand RMB vs. 42.67 ± 2.35 thousand RMB; p < 0.05). The overall complication rate was significantly lower in the TSF group (56%) than in the MEF group (75%). At the final follow-up, no significant differences in the ASAMI scores were observed between the two groups (p > 0.05).
The use of TSF and MEF for ITD-STL can achieve bone reconstruction and soft tissue repair via bone transport, yielding a positive therapeutic effect. However, TSF treatment is a superior method, characterized by better biomechanical properties and fewer complications, particularly in the correction of postoperative tibial axial deviation. However, these benefits might be offset by the economic costs they could entail.
伴有软组织缺损的感染性胫骨缺损（ITD - STL）的治疗在骨科实践中仍然面临重大临床挑战。本研究旨在比较泰勒空间框架（TSF）与单侧外固定器（MEF）在实现ITD - STL的骨与软组织重建方面的临床疗效。
对2010年7月至2022年9月期间收治的49例连续性ITD - STL患者进行回顾性队列研究。数据集包括25例接受TSF治疗的患者，以及24例接受MEF治疗的患者。记录并比较两组患者的人口统计学信息、伤口愈合时间、骨愈合指数、外固定指数、住院费用及并发症情况。在末次随访时（术后平均18.8个月；范围12 - 24个月），采用伊利扎洛夫方法研究与应用协会（ASAMI）评分评估骨愈合及功能恢复情况。然后，进行独立样本t检验或卡方检验等统计分析。
TSF组伤口愈合时间为（89.5 ± 30.6天），MEF组为（86.2 ± 31.8天）（p > 0.05）。TSF组骨愈合指数为（45.49 ± 11.99 d/cm），MEF组为（48.20 ± 13.01 d/cm）（p > 0.05）。TSF组的外固定指数（52.4 ± 7.2 d/cm）显著低于MEF组（58.6 ± 10.3 d/cm）（p < 0.05）。TSF组的总住院费用显著高于MEF组（67.16 ± 2.46千元人民币 vs. 4
