A comparative study of Taylor spatial frame and unilateral external fixator in treatment of tibiofibular open fractures_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

MA He , YAO Hui , ZHANG Tao ,  WAN Chunyou

Department of Limb Orthopedics, Tianjin Hospital, Tianjin, 300211, P.R.China;

Corresponding?author：

WAN Chunyou, Email: wanchunyouxs@163.com

Keywords：

Taylor spatial frame; unilateral external fixator; tibiofibular open fracture; external fixation

DOI：

10.7507/1002-1892.201909120

Video：

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Objective To compare the effectiveness of Taylor spatial frame (TSF) and unilateral external fixator in the treatment of tibiofibular open fractures.Methods Between January 2016 and July 2018, 74 patients with tibiofibular open fracture who met the selection criteria were divided into TSF group (43 cases, fixed with TSF) and unilateral group (31 cases, fixed with unilateral external fixator) according to the principle of entering the group every other day. There was no significant difference in gender, age, affected side, cause of injury, type of fracture between the two groups (P>0.05). The operation time, fracture healing time, removal time of external fixator, and complications were recorded and compared between the two groups. The limb function was evaluated according to Johner-Wruhs criteria for evaluating the final effectiveness of tibial shaft fracture treatment. The recovery of lower limb force line was ecaluated by LUO Congfeng et al. criteria.Results All patients were followed up 8-22 months, with a median of 12 months. All fractures healed, and no complication such as delayed union, nonunion, or osteomyelitis occurred. The operation time, fracture healing time, and removal time of external fixator in TSF group were significantly shorter than those in unilateral group (P<0.05). At 3 months after the removal of the external fixator, the limb function was evaluated according to the Johner-Wruhs standard. In TSF group, 41 cases were excellent, 1 case was good, and 1 case was fair, and the excellent and good rate was 97.67%; in unilateral group, 30 cases were excellent and 1 case was fair, and the excellent and good rate was 96.77%; there was no significant difference between the two groups (P=0.666). At 4 months after operation, the recovery of lower limb force line was ecaluated by LUO Congfeng et al. criterion. In TSF group, 41 cases were excellent, 2 cases were good, and 1 case was fair, and the excellent and good rate was 97.67%; in unilateral group, 29 cases were excellent, 1 case was good, 1 case was fair, and the excellent and good rate was 96.77%; there was no significant difference between the two groups (P=0.666).Conclusion For tibiofibular open fracture, on the premise of fracture healing, TSF technology is superior to unilateral external fixation in terms of shortening operation time, fracture healing time, and removal time of external fixator.

Citation： MA He, YAO Hui, ZHANG Tao, WAN Chunyou. A comparative study of Taylor spatial frame and unilateral external fixator in treatment of tibiofibular open fractures. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(4): 447-451. doi: 10.7507/1002-1892.201909120 Copy

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2.	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.
3.	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.
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5.	Cannon SR, Taylor AR, Lynch AR. Simple external fixation of open and complicated fractures. Injury, 1985, 16(6): 367-370.
6.	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.
7.	葛啟航, 萬春友, 邵醒, 等. Taylor 空間支架結合計算機輔助閉合復位在脛腓骨骨折中的應用研究. 中國修復重建外科雜志, 2019, 33(2): 144-148.
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10.	雍煒, 曹海鯤, 趙遠航, 等. 軸向載荷分擔比指導外固定器動力化的臨床應用. 中國中西醫結合外科雜志, 2019, 25(1): 13-17.
11.	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.
12.	蔣協遠, 王大偉. 骨科臨床療效評價標準. 北京: 人民衛生出版社, 2005: 231-232.
13.	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.
14.	Axelrad TW, Kakar S, Einhorn TA. New technologies for the enhancement of skeletal repair. Injury, 2007, 38(Suppl 1): S49-S62.
15.	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, 2010, 43(4): 687-693.
16.	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.
17.	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.
18.	孫愛國. 局部血腫的形成在骨折早期愈合中的臨床意義. 中國社區醫師 (醫學專業半月刊), 2008, (14): 65.

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. 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.
3. 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.
4. 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.
5. Cannon SR, Taylor AR, Lynch AR. Simple external fixation of open and complicated fractures. Injury, 1985, 16(6): 367-370.
6. 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.
7. 葛啟航, 萬春友, 邵醒, 等. Taylor 空間支架結合計算機輔助閉合復位在脛腓骨骨折中的應用研究. 中國修復重建外科雜志, 2019, 33(2): 144-148.
8. Aarnes GT, Steen H, Ludvigsen P, et al. In vivo assessment of regenerate axial stiffness in distraction osteogenesis. J Orthop Res, 2005, 23(2): 494-498.
9. Krappinger D, Zegg M, Smekal V, et al. Correction of posttraumatic lower leg deformities using the Taylor Spatial Frame. Oper Orthop Traumatol, 2014, 26(5): 520-531.
10. 雍煒, 曹海鯤, 趙遠航, 等. 軸向載荷分擔比指導外固定器動力化的臨床應用. 中國中西醫結合外科雜志, 2019, 25(1): 13-17.
11. 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.
12. 蔣協遠, 王大偉. 骨科臨床療效評價標準. 北京: 人民衛生出版社, 2005: 231-232.
13. 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.
14. Axelrad TW, Kakar S, Einhorn TA. New technologies for the enhancement of skeletal repair. Injury, 2007, 38(Suppl 1): S49-S62.
15. 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, 2010, 43(4): 687-693.
16. 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.
17. 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.
18. 孫愛國. 局部血腫的形成在骨折早期愈合中的臨床意義. 中國社區醫師 (醫學專業半月刊), 2008, (14): 65.

Chinese Journal of Reparative and Reconstructive Surgery

A comparative study of Taylor spatial frame and unilateral external fixator in treatment of tibiofibular open fractures

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