France Jonathan, Tucker Adam, Nightingale Jessica, Taylor Andrew, Craxford Simon, Ollivere Benjamin
Queens Medical Centre, Nottingham, UK.
Belfast Health and Social Care Trust, Belfast, UK.
Bone Jt Open. 2025 Jul 14;6(7):816-821. doi: 10.1302/2633-1462.67.BJO-2025-0023.R1.
The use of circular frames in the management of tibia fractures and deformity correction is well established in the literature. The Taylor Spatial Frame (TSF) is the most widely used hexapod device globally. However, the majority of published papers are small in patient numbers, contain primary and revision cases, and outcomes are therefore unclear. In this study we evaluate the clinical and radiological outcomes of patients with tibial fractures treated primarily with a TSF.
Patients were identified from a prospective trauma database at a UK major trauma centre. An analysis of patient records and radiographs was performed for the study. Patient demographics, comorbidities, frame construct, time in frame, union rates, and complications of treatment were analyzed.
Between September 2009 and January 2020, 111 patients with tibial fractures managed primarily with a TSF were included. The majority of patients (86, 77.5%) sustained fractures to the tibial shaft, leaving nine plateau (8.1%) and 16 pilon fractures (14.4%). Of these, 55 (49.6%) were open and 56 (50.4%) were closed. Of the open fractures, seven were classified as Gustilo and Anderson grade 3A and 41 (74.5%) were classified as grade 3B. The overall union rate for primary TSF was 85%, with a mean time to union of 191 days (SD 90). A total of 15 patients (13.5%) required either open reduction and internal fixation (n = 6, 5.4%) or intramedullary nail (n = 9, 8.2%) to achieve bony union. Five patients (4.5%) developed a deep infection requiring invasive treatment. Two patients (1.8%) required an eventual amputation for an infected nonunion; both of these patients sustained an initially closed fracture. Overall limb salvage at two years was 98.2%.
The TSF remains an established option in the surgical management of patients with complex injuries to the tibia, with good rates of limb salvage within this challenging patient subgroup.
文献中已充分证实环形外固定架在胫骨骨折治疗及畸形矫正中的应用。泰勒空间外固定架（TSF）是全球使用最广泛的六足式外固定装置。然而，大多数已发表的论文病例数较少，包含初次治疗和翻修病例，因此结果尚不清楚。在本研究中，我们评估主要采用TSF治疗的胫骨骨折患者的临床和影像学结果。
从英国一家主要创伤中心的前瞻性创伤数据库中识别患者。对患者记录和X线片进行分析以开展本研究。分析患者的人口统计学资料、合并症、外固定架结构、佩戴外固定架时间、骨愈合率及治疗并发症。
2009年9月至2020年1月期间，纳入111例主要采用TSF治疗的胫骨骨折患者。大多数患者（86例，77.5%）为胫骨干骨折，9例（8.1%）为胫骨平台骨折，16例（14.4%）为Pilon骨折。其中，55例（49.6%）为开放性骨折，56例（50.4%）为闭合性骨折。在开放性骨折中，7例为Gustilo和Anderson 3A级，41例（74.5%）为3B级。初次使用TSF的总体骨愈合率为85%，平均骨愈合时间为191天（标准差90天）。共有15例患者（13.5%）需要切开复位内固定（6例，5.4%）或髓内钉固定（9例，8.2%）以实现骨愈合。5例患者（4.5%）发生深部感染，需要进行侵入性治疗。2例患者（1.8%）因感染性骨不连最终需要截肢；这2例患者最初均为闭合性骨折。两年时的总体保肢率为98.2%。
对于胫骨复杂损伤患者，TSF仍是手术治疗的一种既定选择，在这一具有挑战性的患者亚组中保肢率良好。
