Effect of axial stress stimulation on tibial and fibular open fractures healing after Taylor space stent fixation_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

GE Qihang ¹ ,  WAN Chunyou ² , LIU Yabei ¹ , JI Xu ¹ , MA Jihai ¹ , CAO Haikun ¹ , YONG Wei ¹ , LIU Zhao ³ , ZHANG Ningning ³

1. Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, P.R.China;
2. Department of Trauma Orthopedics, Tianjin Hospital, Tianjin, 300211, P.R.China;
3. Graduate School, Tianjin Medical University, Tianjin, 300070, P.R.China;

Corresponding?author：

WAN Chunyou, Email: wanchunyouxs@163.com

Keywords：

Axial stress stimulation; tibial and fibular open fractures; Taylor space stent

DOI：

10.7507/1002-1892.201703072

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the effect of axial stress stimulation on tibial and fibular open fractures healing after Taylor space stent fixation. Methods The data of 45 cases with tibial and fibular open fractures treated by Taylor space stent fixation who meet the selection criteria between January 2015 and June 2016 were retrospectively analysed. The patients were divided into trial group (23 cases) and control group (22 cases) according to whether the axial stress stimulation was performed after operation. There was no significant difference in gender, age, affected side, cause of injury, type of fracture, and interval time from injury to operation between 2 groups (P>0.05). The axial stress stimulation was performed in trial group after operation. The axial load sharing ratio was tested, and when the value was less than 10%, the external fixator was removed. The fracture healing time, full weight-bearing time, and external fixator removal time were recorded and compared. After 6 months of external fixator removal, the function of the limb was assessed by Johner-Wruhs criteria for evaluation of final effectiveness of treatment of tibial shaft fractures. Results There were 2 and 3 cases of needle foreign body reaction in trial group and control group, respectively, and healed after symptomatic anti allergic treatment. All the patients were followed up 8-12 months with an average of 10 months. All the fractures reached clinical healing, no complication such as delayed union, nonunion, or osteomyelitis occurred. The fracture healing time, full weight-bearing time, and external fixator removal time in trial group were significantly shorter than those in control group (P<0.05). After 6 months of external fixator removal, the function of the limb was excellent in 13 cases, good in 6 cases, fair in 3 cases, and poor in 1 case in trial group, with an excellent and good rate of 82.6%; and was excellent in 5 cases, good in 10 cases, fair in 4 cases, and poor in 3 cases in control group, with an excellent and good rate of 68.2%, showing significant difference between 2 groups (Z=–2.146, P=0.032). Conclusion The axial stress stimulation of Taylor space stent fixation can promote the healing of tibial and fibular open fractures and promote local bone formation at fracture site.

Citation： GE Qihang, WAN Chunyou, LIU Yabei, JI Xu, MA Jihai, CAO Haikun, YONG Wei, LIU Zhao, ZHANG Ningning. Effect of axial stress stimulation on tibial and fibular open fractures healing after Taylor space stent fixation. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(8): 931-935. doi: 10.7507/1002-1892.201703072 Copy

1.	Hedia HS, Noha F. Improved Stress Shielding on a Cementless Tibia Tray using Functionally Graded Material. Material Testing, 2013, 55(11-12): 745-751.
2.	Completo A, Fonseca F, Sim?es JA. Strain shielding in proximal tibia of stemmed knee prosthesis: Experimental study. J Biomech, 2008, 41(3): 560-566.
3.	Cawley DT, Kelly N, Simpkin A, et al. Full and surface tibial cementation in total knee arthroplasty: a biomechanical investigation of stress distribution and remodeling in the tibia. Clin Biomech (Bristol, Avon), 2012, 27(4): 390-397.
4.	Zhao H, Zhao H, Wang J, et al. Stress stimulation induced resistance of plant. Colloids Surf B Biointerfaces, 2005, 43(3-4): 174-178.
5.	Seebohm G, Strutzseebohm N, Ursu ON, et al. Altered stress stimulation of inward rectifier potassium channels in Andersen-Tawil syndrome. FASEB J, 2012, 26(2): 513-522.
6.	Ding ZQ, Gao J. Development of the rap system of stress stimulation and clinical study of on the promoting effect on the healing of closed tibia shaft fracture. J Clin Orthop, 2006, 11(2): 161-163.
7.	全先輝, 萬春友, 劉磊, 等. Taylor 空間支架外固定治療脛腓骨開放性骨折. 中醫正骨, 2015, 27(10): 30-31.
8.	盧慶威, 萬春友, 張弢, 等. 軸向載荷力學測試在脛腓骨骨折術后外固定器拆除中的臨床應用. 中國修復重建外科雜志, 2016, 30(9): 1085-1088.
9.	Johner R, Wruhs O. Classification of tibial shaft fracturesand correlation with results after rigid internal fixation. Clin Orthop Relat Res, 1983, (178): 7-25.
10.	趙宇宙. 脛骨干骨折的手術治療. 中國中醫藥現代遠程教育, 2009, 7(7): 74-75.
11.	Oehler RL, Maldonado A, Mastorides SM, et al. Cryptococcal Osteomyelitis Complicating Intestinal Lymphangiectasia: A Case Report and Review of the Literature. Infectious Disease in Clinical Practice, 2007, 15(2): 125-128.
12.	Ye D, Xu Y, Zhang H, et al. Effects of low-dose microwave on healing of fractures with titanium alloy internal fixation: an experimental study in a rabbit model. PLoS One, 2013, 8(9): e75756.
13.	Chondros TG, Deligianni DD, Milidonis KF, et al. Wire tensioning with integrated load-cell in the Ilizarov orthopedic external fixation system. Mechanism and Machine Theory, 2014, 79: 109-123.
14.	Schievano S, Taylor AM, Capelli C, et al. Patient specific finite element analysis results in more accurate prediction of stent fractures: application to percutaneous pulmonary valve implantation. J Biomech, 2009, 43(4): 687-693.
15.	Zhuang P, Hong J, Chen W, et al. Clinical analysis of the rap stress stimulator applied for crus fracture after skeletal external fixation. Arch Med Sci, 2015, 11(3): 612-618.
16.	王春慶, 李青, 劉剛, 等. 外固定支架在嚴重多發傷并脛腓骨開放性骨折中應用的病例對照研究. 中國骨傷, 2008, 21(6): 417-418.
17.	張利獻, 席學義, 張文獻. 骨折后局部血腫對骨痂形成的意義. 中華實用醫藥雜志, 2005, 5(8): 557.
18.	Snyder BM, Conley J, Koval KJ. Does low-intensity pulsed ultrasound reduce time to fracture healing? A meta-analysis. Am J Orthop (Belle Mead NJ), 2012, 41(2): E12-19.
19.	沈保磊, 丁真奇, 黃國峰, 等. 應力叩擊儀促進脛骨骨折外固定架術后骨折愈合的臨床觀察. 現代生物醫學進展, 2016, 16(33): 6491-6494.
20.	王西彬, 孫永強. 縱向生理加壓外固定器治療脛腓骨雙骨折的安全性. 中國組織工程研究, 2012, 16(17): 3126-3129.
21.	Wan L, Zhang F, He Q, et al. EPO promotes bone repair through enhanced cartilaginous callus formation and angiogenesis. PLoS One, 2014, 9(7): e102010.
22.	任可, 張存才, 許碩貴, 等. 持續動態壓應力對實驗性骨折愈合的影響. 第四軍醫人學學報, 2004, 25(1): 41-45.

1. Hedia HS, Noha F. Improved Stress Shielding on a Cementless Tibia Tray using Functionally Graded Material. Material Testing, 2013, 55(11-12): 745-751.
2. Completo A, Fonseca F, Sim?es JA. Strain shielding in proximal tibia of stemmed knee prosthesis: Experimental study. J Biomech, 2008, 41(3): 560-566.
3. Cawley DT, Kelly N, Simpkin A, et al. Full and surface tibial cementation in total knee arthroplasty: a biomechanical investigation of stress distribution and remodeling in the tibia. Clin Biomech (Bristol, Avon), 2012, 27(4): 390-397.
4. Zhao H, Zhao H, Wang J, et al. Stress stimulation induced resistance of plant. Colloids Surf B Biointerfaces, 2005, 43(3-4): 174-178.
5. Seebohm G, Strutzseebohm N, Ursu ON, et al. Altered stress stimulation of inward rectifier potassium channels in Andersen-Tawil syndrome. FASEB J, 2012, 26(2): 513-522.
6. Ding ZQ, Gao J. Development of the rap system of stress stimulation and clinical study of on the promoting effect on the healing of closed tibia shaft fracture. J Clin Orthop, 2006, 11(2): 161-163.
7. 全先輝, 萬春友, 劉磊, 等. Taylor 空間支架外固定治療脛腓骨開放性骨折. 中醫正骨, 2015, 27(10): 30-31.
8. 盧慶威, 萬春友, 張弢, 等. 軸向載荷力學測試在脛腓骨骨折術后外固定器拆除中的臨床應用. 中國修復重建外科雜志, 2016, 30(9): 1085-1088.
9. Johner R, Wruhs O. Classification of tibial shaft fracturesand correlation with results after rigid internal fixation. Clin Orthop Relat Res, 1983, (178): 7-25.
10. 趙宇宙. 脛骨干骨折的手術治療. 中國中醫藥現代遠程教育, 2009, 7(7): 74-75.
11. Oehler RL, Maldonado A, Mastorides SM, et al. Cryptococcal Osteomyelitis Complicating Intestinal Lymphangiectasia: A Case Report and Review of the Literature. Infectious Disease in Clinical Practice, 2007, 15(2): 125-128.
12. Ye D, Xu Y, Zhang H, et al. Effects of low-dose microwave on healing of fractures with titanium alloy internal fixation: an experimental study in a rabbit model. PLoS One, 2013, 8(9): e75756.
13. Chondros TG, Deligianni DD, Milidonis KF, et al. Wire tensioning with integrated load-cell in the Ilizarov orthopedic external fixation system. Mechanism and Machine Theory, 2014, 79: 109-123.
14. Schievano S, Taylor AM, Capelli C, et al. Patient specific finite element analysis results in more accurate prediction of stent fractures: application to percutaneous pulmonary valve implantation. J Biomech, 2009, 43(4): 687-693.
15. Zhuang P, Hong J, Chen W, et al. Clinical analysis of the rap stress stimulator applied for crus fracture after skeletal external fixation. Arch Med Sci, 2015, 11(3): 612-618.
16. 王春慶, 李青, 劉剛, 等. 外固定支架在嚴重多發傷并脛腓骨開放性骨折中應用的病例對照研究. 中國骨傷, 2008, 21(6): 417-418.
17. 張利獻, 席學義, 張文獻. 骨折后局部血腫對骨痂形成的意義. 中華實用醫藥雜志, 2005, 5(8): 557.
18. Snyder BM, Conley J, Koval KJ. Does low-intensity pulsed ultrasound reduce time to fracture healing? A meta-analysis. Am J Orthop (Belle Mead NJ), 2012, 41(2): E12-19.
19. 沈保磊, 丁真奇, 黃國峰, 等. 應力叩擊儀促進脛骨骨折外固定架術后骨折愈合的臨床觀察. 現代生物醫學進展, 2016, 16(33): 6491-6494.
20. 王西彬, 孫永強. 縱向生理加壓外固定器治療脛腓骨雙骨折的安全性. 中國組織工程研究, 2012, 16(17): 3126-3129.
21. Wan L, Zhang F, He Q, et al. EPO promotes bone repair through enhanced cartilaginous callus formation and angiogenesis. PLoS One, 2014, 9(7): e102010.
22. 任可, 張存才, 許碩貴, 等. 持續動態壓應力對實驗性骨折愈合的影響. 第四軍醫人學學報, 2004, 25(1): 41-45.

Chinese Journal of Reparative and Reconstructive Surgery

Effect of axial stress stimulation on tibial and fibular open fractures healing after Taylor space stent fixation

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content