The assessment of the application of Taylor spatial frame in treatment of intermediate or distal tibiofibula fractures_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Ningning ¹ ,  WAN Chunyou ² , ZHANG Tao ² , MA Jihai ³ , LIU Zhao ¹ , WANG Mingjie ² , GE Qihang ³

1. Graduate School of Tianjin Medical University, Tianjin, 300070, P.R.China;
2. No.1 Ward of Limb Orthopaedic and Reconstruction, Tianjin Hospital, Tianjin, 300211, P.R.China;
3. Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, P.R.China;

Corresponding?author：

WAN Chunyou, Email: wanchunyouxs@163.com

Keywords：

Tibiofibula fractures; Taylor spatial frame; closed reduction; corrective force line

DOI：

10.7507/1002-1892.201712095

Video：

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Objective To determine the effectiveness and the safety of the Taylor spatial frame in treatment of intermediate or distal tibiofibula fractures. Methods The clinical data of 74 patients with intermediate or distal tibiofibular fractures treated between January 2015 and January 2017 were retrospectively analyzed. According to fixation methods, they were divided into internal fixation group (26 cases) and external fixation group (48 cases). There was no significant difference in the age, gender, cause of injury, type of fracture, time from injury to operation between 2 groups (P>0.05). The intraoperative blood loss, fracture healing time, fixator removal time, and complications were recorded and compared. The final function evaluation criteria of Johner-Wruhs humeral shaft fracture were used to evaluate the function of the affected limb. The lower limb force line recovery after operation was evaluated according to the standard evaluation of LUO Congfenget al. Results Both groups were followed up 6-22 months (median, 14 months). All patients obtained the fracture healing. The intraoperative blood loss, fracture healing time, and fixator removal time were significantly higher in the internal fixation group than those in the external fixation group (P<0.05). There were 1 case of plate exposure, 1 case of delayed fracture healing, and 1 case of plate fracture in the internal fixation group; and there were 2 cases of delayed fracture healing and 4 cases of soft tissue defect in the external fixation group; no significant difference was found in the incidence of complications between 2 groups (χ²=0.015, P=0.904). The function of the affected limb was evaluated by Johner-Wruhs standard at 10 months after operation, the results was excellent in 19 cases, good in 5 cases, and fair in 2 cases in the internal fixation group, with an excellent and good rate of 92.3%; the results was excellent in 42 cases, good in 3 cases, and fair in 2 cases in the external fixation group, with an excellent and good rate of 95.7%; showing no significant difference between 2 groups (χ²=0.392, P=0.531). The lower limb force line recovery after operation was evaluated according to the standard evaluation of LUO Congfeng et al.at 4 months after operation, the results was excellent in 24 cases, fair in 1 case, poor in 1 case in the internal fixation group, with an excellent and good rate of 92.3%; the results was excellent in 46 cases, fair in 1 case, poor in 1 case in the external fixation group, with an excellent and good rate of 95.8%; showing no significant difference between 2 groups (χ²=0.520, P=0.471). Conclusion The use of Taylor spatial frame in the treatment of the intermediate or distal tibiofibular fractures can obviously reduce the healing time and complications than the internal fixation of the plate. It can reduce the fracture treatment cycle and is beneficial to the fracture healing and limb function recovery, which is relatively safe and reliable.

Citation： ZHANG Ningning, WAN Chunyou, ZHANG Tao, MA Jihai, LIU Zhao, WANG Mingjie, GE Qihang. The assessment of the application of Taylor spatial frame in treatment of intermediate or distal tibiofibula fractures. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(8): 1012-1017. doi: 10.7507/1002-1892.201712095 Copy

1.	萬春友, 金鴻賓, 張金利, 等. 脛腓骨復雜骨折固定研究進展. 中國矯形外科雜志, 2009, 17(12): 918-920.
2.	Zenios M. The use of the taylor spatial frame for the treatment of unstable tibial fractures in children. J Orthop Trauma, 2013, 27(10): 563-568.
3.	Sala F, Elbatrawy Y, Thabet AM, et al. Taylor spatial frame fixation in patients with multiple traumatic injuries: study of 57 long-bone fractures. J Orthop Trauma, 2013, 27(8): 442-450.
4.	Sharma H, Nunn T. Conversion of open tibial Ⅲb to Ⅲa fractures using intentional temporary deformation and the Taylor Spatial Frame. Strategies Trauma Limb Reconstr, 2013, 8(2): 133-140.
5.	葛啟航, 萬春友, 劉亞北, 等. 脛腓骨開放骨折 Taylor 空間支架外固定術后軸向應力刺激對骨折愈合的影響研究. 中國修復重建外科雜志, 2017, 31(8): 931-935.
6.	王亞洲, 徐佳, 康慶林. Taylor 空間支架的臨床應用進展. 中國矯形外科雜志, 2014, 22(19): 1773-1777.
7.	Aarnes GT, Steen T, Ludvigsen P, et al. In vivo assessment of regenerate axial stiffness in distraction osteogenesis. J Orthop Res, 2005, 23(2): 494-498.
8.	秦泗河. 下肢畸形與殘缺外科治療新技術新觀念概論. 中國矯形外科雜志, 2011, 19(7): 599-602.
9.	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, 34.
10.	郭志民, 石玲玲, 田勝, 等. 肢體短縮延長術治療脛骨感染性骨缺損及慢性骨髓炎療效觀察. 中國修復重建外科雜志, 2017, 31(8): 941-945.
11.	Yasuda T, Arai M, Sato K, et al. A Gustilo type 3B open tibial fracture treated with a proximal flexor hallucis longus flap: a case report. J Orthop Case Rep, 2017, 7(2): 70-73.
12.	Menakaya CU, Rigby AS, Hadland Y, et al. Fracture healing following high energy tibial trauma: Ilizarov versus taylor spatial frame. Ann R Coll Surg Engl, 2017, 96(2): 106-110.
13.	韓立仁, 趙北, 穆衛東, 等. 外固定架加鋼板治療伴有脛骨骨缺損的開放性脛腓骨骨折. 中華創傷雜志, 2013, 29(3): 258-261.
14.	Dammerer D, Kirschbichler K, Donnan L, et al. Clinical value of the Taylor Spatial Frame: a comparison with the Ilizarov and Orthofix fixators. J Child Orthop, 2011, 5(5): 343-349.
15.	Wukich DK, Belczyk RJ. An introduction to the Taylor spatial frame for foot and ankle applications. Operative Tech Orthop, 2006, 16(1): 2-9.
16.	Henderson DJ, Rushbrook JL, Harwood PJ, et al. What are the biomechanical properties of the Taylor spatial frame^TM? Clin Orthop Relat Res, 2017, 475(5): 1472-1482.
17.	Rogers MJ, Mc Fadyen I, Livingstone JA, et al. Computer hexapod assisted orthopaedic surgery ( CHAOS) in the correction of long bone fracture and deformity. J Orthop Trauma, 2007, 21(5): 337-342.
18.	Lahoti O, Findlay I, Shetty S, et al. Intentional deformation and closure of soft tissue defect in open tibial fractures with a Taylor spatial frame-a simple technique. J Orthop Trauma, 2013, 27(8): 451-456.
19.	馬繼海, 張濤, 海碧霞, 等. 骨外固定動力化治療開放性脛腓骨骨折. 中國修復重建外科雜志, 2018, 32(2): 174-177.
20.	Paley D, Maar DC. Ilizarov bone transport treatment for tibial defects. J Orthop Trauma, 2000, 14(2): 76-85.
21.	宋文超, 張思森, 陳勇, 等. 可控性應力與微動對骨折愈合影響的CT影像結果. 中華創傷骨科雜志, 2015, 17(7): 624-627.
22.	喻鑫罡, 張先龍, 曾炳芳. 低頻可控性微動影響長骨骨折愈合的實驗研究. 中華創傷骨科雜志, 2005, 7(8) :744-748.

1. 萬春友, 金鴻賓, 張金利, 等. 脛腓骨復雜骨折固定研究進展. 中國矯形外科雜志, 2009, 17(12): 918-920.
2. Zenios M. The use of the taylor spatial frame for the treatment of unstable tibial fractures in children. J Orthop Trauma, 2013, 27(10): 563-568.
3. Sala F, Elbatrawy Y, Thabet AM, et al. Taylor spatial frame fixation in patients with multiple traumatic injuries: study of 57 long-bone fractures. J Orthop Trauma, 2013, 27(8): 442-450.
4. Sharma H, Nunn T. Conversion of open tibial Ⅲb to Ⅲa fractures using intentional temporary deformation and the Taylor Spatial Frame. Strategies Trauma Limb Reconstr, 2013, 8(2): 133-140.
5. 葛啟航, 萬春友, 劉亞北, 等. 脛腓骨開放骨折 Taylor 空間支架外固定術后軸向應力刺激對骨折愈合的影響研究. 中國修復重建外科雜志, 2017, 31(8): 931-935.
6. 王亞洲, 徐佳, 康慶林. Taylor 空間支架的臨床應用進展. 中國矯形外科雜志, 2014, 22(19): 1773-1777.
7. Aarnes GT, Steen T, Ludvigsen P, et al. In vivo assessment of regenerate axial stiffness in distraction osteogenesis. J Orthop Res, 2005, 23(2): 494-498.
8. 秦泗河. 下肢畸形與殘缺外科治療新技術新觀念概論. 中國矯形外科雜志, 2011, 19(7): 599-602.
9. 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, 34.
10. 郭志民, 石玲玲, 田勝, 等. 肢體短縮延長術治療脛骨感染性骨缺損及慢性骨髓炎療效觀察. 中國修復重建外科雜志, 2017, 31(8): 941-945.
11. Yasuda T, Arai M, Sato K, et al. A Gustilo type 3B open tibial fracture treated with a proximal flexor hallucis longus flap: a case report. J Orthop Case Rep, 2017, 7(2): 70-73.
12. Menakaya CU, Rigby AS, Hadland Y, et al. Fracture healing following high energy tibial trauma: Ilizarov versus taylor spatial frame. Ann R Coll Surg Engl, 2017, 96(2): 106-110.
13. 韓立仁, 趙北, 穆衛東, 等. 外固定架加鋼板治療伴有脛骨骨缺損的開放性脛腓骨骨折. 中華創傷雜志, 2013, 29(3): 258-261.
14. Dammerer D, Kirschbichler K, Donnan L, et al. Clinical value of the Taylor Spatial Frame: a comparison with the Ilizarov and Orthofix fixators. J Child Orthop, 2011, 5(5): 343-349.
15. Wukich DK, Belczyk RJ. An introduction to the Taylor spatial frame for foot and ankle applications. Operative Tech Orthop, 2006, 16(1): 2-9.
16. Henderson DJ, Rushbrook JL, Harwood PJ, et al. What are the biomechanical properties of the Taylor spatial frame^TM? Clin Orthop Relat Res, 2017, 475(5): 1472-1482.
17. Rogers MJ, Mc Fadyen I, Livingstone JA, et al. Computer hexapod assisted orthopaedic surgery ( CHAOS) in the correction of long bone fracture and deformity. J Orthop Trauma, 2007, 21(5): 337-342.
18. Lahoti O, Findlay I, Shetty S, et al. Intentional deformation and closure of soft tissue defect in open tibial fractures with a Taylor spatial frame-a simple technique. J Orthop Trauma, 2013, 27(8): 451-456.
19. 馬繼海, 張濤, 海碧霞, 等. 骨外固定動力化治療開放性脛腓骨骨折. 中國修復重建外科雜志, 2018, 32(2): 174-177.
20. Paley D, Maar DC. Ilizarov bone transport treatment for tibial defects. J Orthop Trauma, 2000, 14(2): 76-85.
21. 宋文超, 張思森, 陳勇, 等. 可控性應力與微動對骨折愈合影響的CT影像結果. 中華創傷骨科雜志, 2015, 17(7): 624-627.
22. 喻鑫罡, 張先龍, 曾炳芳. 低頻可控性微動影響長骨骨折愈合的實驗研究. 中華創傷骨科雜志, 2005, 7(8) :744-748.

Chinese Journal of Reparative and Reconstructive Surgery

The assessment of the application of Taylor spatial frame in treatment of intermediate or distal tibiofibula fractures

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