Application of Taylor spatial frame combined with computer-assisted closed reduction in the treatment of tibiofibular fractures_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

GE Qihang ¹ ,  WAN Chunyou ² , SHAO Xing ³ , ZHANG Tao ² , JIA Peng ² , MEI Xiaolong ² , WANG Mingjie ² , ZHAO Yuanhang ¹ , PAN Qingsong ¹ , MA Jihai ⁴

1. Graduate School of 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 of Guizhou University of Traditional Chinese Medicine, Guiyang Guizhou, 550005, P.R.China;
4. Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou Gansu, 730050, P.R.China;

Corresponding?author：

WAN Chunyou, Email: wanchunyouxs@163.com

Keywords：

Tibiofibular fractures; Taylor spatial frame; computer-aided closed reduction

DOI：

10.7507/1002-1892.201807008

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Objective To explore the effectiveness of Taylor spatial frame (TSF) in the treatment of tibiofibular fractures and computer-assisted closed reduction.Methods The clinical data of 30 cases of tibiofibular fractures with soft tissue injury treated with TSF between January 2015 and September 2017 was retrospectively analyzed. According to different reduction methods, the patients were divided into control group (15 cases, open reduction in TSF external fixation) and trial group (15 cases, closed reduction in 1-3 days after TSF external fixation). There was no significant difference in the general data such as gender, age, affected side, cause of injury, AO classification of fracture, time from injury to operation between the two groups (P>0.05). The operation time, intraoperative blood loss, fracture healing time, and removal time of external fixator were recorded and compared between the two groups. At 3 months after removal of external fixator, the limb function was evaluated according to Johner-Wruhs criteria for evaluating the final effect of tibial shaft fracture treatment.Results Both groups were followed up 9-16 months, with an average of 14 months. The operation time, intraoperative blood loss, fracture healing time, and removal time of external fixator in the trial group were significantly shorter than those in the control group (P<0.05). There were 2 cases of superficial infection of the external fixation (1 case in each group), 1 case of incision infection (control group), 1 case of delayed fracture healing (control group), 2 cases of traumatic arthritis (1 case in each group); no significant difference was found in the incidence of complications between the two groups (χ²=0.370, P=0.543). The wounds of soft tissue defect healed by the first intension in both groups. At 3 months after removal of the external fixator, the limb function results in the trial group were excellent in 3 cases, good in 9 cases, fair in 2 cases, and poor in 1 case, and the excellent and good rate was 80.0%; in the control group, the results were excellent in 3 cases, good in 8 cases, fair in 3 cases, and poor in 1 case, and the excellent and good rate was 73.3%. There was no significant difference in incidence of complication between the two groups (χ²=0.917, P=0.821).Conclusion Compared with intraoperative open reduction, postoperative computer-aided closed reduction can shorten the operation time, reduce the intraoperative blood loss, reduce the risk of long-term operation, avoid to destroy the blood supply of fracture end, shorten the healing time of fracture and the wearing time of stent, and alleviate the pain of patients after TSF treatment of tibiofibular fracture.

Citation： GE Qihang, WAN Chunyou, SHAO Xing, ZHANG Tao, JIA Peng, MEI Xiaolong, WANG Mingjie, ZHAO Yuanhang, PAN Qingsong, MA Jihai. Application of Taylor spatial frame combined with computer-assisted closed reduction in the treatment of tibiofibular fractures. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(2): 144-148. doi: 10.7507/1002-1892.201807008 Copy

1.	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.
2.	Manner HM, Huebl M, Radler C, et al. Accuracy of complex lower-limb deformity correction with external fixation: a comparison of the Taylor Spatial Frame with the Ilizarov ring fixator. J Child Orthop, 2007, 1(1): 55-61.
3.	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.
4.	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.
5.	Johner R, Wruhs O. Classification of tibial shaft fracturesand correlation with results after rigid internal fixation. Clin Orthop Relat Res, 1983, (178): 7-25.
6.	Fu QG, Liu XW, Xu SG, et al. Stress-shielding effect of nitinol Swan-like memory compressive connector on fracture healing of upper limb. J Mater Eng Perform, 2009, 18(5-6): 797-804.
7.	王德龍, 劉志成. 家兔骨延長術中固定剛度對骨愈合的影響. 北京生物醫學工程, 2017, 36(5): 488-494.
8.	夏和桃. 外固定器剛度對骨折愈合的影響. 中華創傷骨科雜志, 2007, 9(12): 1170-1172.
9.	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.
10.	李公倫, 王國蕊, 韓銳華, 等. 多功能外固定支架治療四肢嚴重開放性骨折病例報道. 生物骨科材料與臨床研究, 2018, 15(4): 73-74.
11.	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.
12.	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.
13.	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.
14.	曾憲鐵, 龐貴根, 王宏川, 等. 閉合復位經皮插入鎖定加壓鋼板技術在脛骨遠端骨折的應用. 中國矯形外科雜志, 2008, 16(20): 1584-1585.
15.	張英澤, 韓志杰, 劉歡, 等. 河北醫科大學第三醫院骨折治療理念與原則. 河北醫科大學學報, 2017, 38(9): 1093-1095.
16.	劉彥士, 馬信龍, 萬春友, 等. 計算機輔助測量在Taylor外固定支架治療脛腓骨骨折中的應用. 中國矯形外科雜志, 2017, 25(16): 1457-1462.
17.	Billings A, Scott DF, Camargo MP, et al. High tibial osteotomy with a calibrated osteotomy guide, rigid internal fixation, and early motion. Long-term follow-up. J Bone Joint Surg (Am), 2000, 82(1): 70-79.
18.	Gelalis ID, Politis AN, Arnaoutoglou CM, et al. Diagnostic and treatment modalities in nonunions of the femoral shaft: a review. Injury, 2012, 43(7): 980-988.

1. 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.
2. Manner HM, Huebl M, Radler C, et al. Accuracy of complex lower-limb deformity correction with external fixation: a comparison of the Taylor Spatial Frame with the Ilizarov ring fixator. J Child Orthop, 2007, 1(1): 55-61.
3. 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.
4. 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.
5. Johner R, Wruhs O. Classification of tibial shaft fracturesand correlation with results after rigid internal fixation. Clin Orthop Relat Res, 1983, (178): 7-25.
6. Fu QG, Liu XW, Xu SG, et al. Stress-shielding effect of nitinol Swan-like memory compressive connector on fracture healing of upper limb. J Mater Eng Perform, 2009, 18(5-6): 797-804.
7. 王德龍, 劉志成. 家兔骨延長術中固定剛度對骨愈合的影響. 北京生物醫學工程, 2017, 36(5): 488-494.
8. 夏和桃. 外固定器剛度對骨折愈合的影響. 中華創傷骨科雜志, 2007, 9(12): 1170-1172.
9. 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.
10. 李公倫, 王國蕊, 韓銳華, 等. 多功能外固定支架治療四肢嚴重開放性骨折病例報道. 生物骨科材料與臨床研究, 2018, 15(4): 73-74.
11. 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.
12. 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.
13. 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.
14. 曾憲鐵, 龐貴根, 王宏川, 等. 閉合復位經皮插入鎖定加壓鋼板技術在脛骨遠端骨折的應用. 中國矯形外科雜志, 2008, 16(20): 1584-1585.
15. 張英澤, 韓志杰, 劉歡, 等. 河北醫科大學第三醫院骨折治療理念與原則. 河北醫科大學學報, 2017, 38(9): 1093-1095.
16. 劉彥士, 馬信龍, 萬春友, 等. 計算機輔助測量在Taylor外固定支架治療脛腓骨骨折中的應用. 中國矯形外科雜志, 2017, 25(16): 1457-1462.
17. Billings A, Scott DF, Camargo MP, et al. High tibial osteotomy with a calibrated osteotomy guide, rigid internal fixation, and early motion. Long-term follow-up. J Bone Joint Surg (Am), 2000, 82(1): 70-79.
18. Gelalis ID, Politis AN, Arnaoutoglou CM, et al. Diagnostic and treatment modalities in nonunions of the femoral shaft: a review. Injury, 2012, 43(7): 980-988.

Chinese Journal of Reparative and Reconstructive Surgery

Application of Taylor spatial frame combined with computer-assisted closed reduction in the treatment of tibiofibular fractures

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