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.	万春友, 金鸿宾, 张金利, 等. 胫腓骨复杂骨折固定研究进展. 中国矫形外科杂志, 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.	葛启航, 万春友, 邵醒, 等. Taylor 空间支架结合计算机辅助闭合复位在胫腓骨骨折中的应用研究. 中国修复重建外科杂志, 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.	雍炜, 曹海鲲, 赵远航, 等. 轴向载荷分担比指导外固定器动力化的临床应用. 中国中西医结合外科杂志, 2019, 25(1): 13-17.
11.	秦泗河. 下肢畸形与残缺外科治疗新技术新观念概论. 中国矫形外科杂志, 2011, 19(7): 599-602.
12.	蒋协远, 王大伟. 骨科临床疗效评价标准. 北京: 人民卫生出版社, 2005: 231-232.
13.	赵宇宙. 胫骨干骨折的手术治疗. 中国中医药现代远程教育, 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.	王春庆, 李青, 刘刚, 等. 外固定支架在严重多发伤并胫腓骨开放性骨折中应用的病例对照研究. 中国骨伤, 2008, 21(6): 417-418.
18.	孙爱国. 局部血肿的形成在骨折早期愈合中的临床意义. 中国社区医师 (医学专业半月刊), 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. 万春友, 金鸿宾, 张金利, 等. 胫腓骨复杂骨折固定研究进展. 中国矫形外科杂志, 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. 葛启航, 万春友, 邵醒, 等. Taylor 空间支架结合计算机辅助闭合复位在胫腓骨骨折中的应用研究. 中国修复重建外科杂志, 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. 雍炜, 曹海鲲, 赵远航, 等. 轴向载荷分担比指导外固定器动力化的临床应用. 中国中西医结合外科杂志, 2019, 25(1): 13-17.
11. 秦泗河. 下肢畸形与残缺外科治疗新技术新观念概论. 中国矫形外科杂志, 2011, 19(7): 599-602.
12. 蒋协远, 王大伟. 骨科临床疗效评价标准. 北京: 人民卫生出版社, 2005: 231-232.
13. 赵宇宙. 胫骨干骨折的手术治疗. 中国中医药现代远程教育, 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. 王春庆, 李青, 刘刚, 等. 外固定支架在严重多发伤并胫腓骨开放性骨折中应用的病例对照研究. 中国骨伤, 2008, 21(6): 417-418.
18. 孙爱国. 局部血肿的形成在骨折早期愈合中的临床意义. 中国社区医师 (医学专业半月刊), 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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