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

Video：

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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.	卢庆威, 万春友, 张弢, 等. 轴向载荷力学测试在胫腓骨骨折术后外固定器拆除中的临床应用. 中国修复重建外科杂志, 2016, 30(9): 1085-1088.
4.	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.
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.	王德龙, 刘志成. 家兔骨延长术中固定刚度对骨愈合的影响. 北京生物医学工程, 2017, 36(5): 488-494.
8.	夏和桃. 外固定器刚度对骨折愈合的影响. 中华创伤骨科杂志, 2007, 9(12): 1170-1172.
9.	葛启航, 万春友, 刘亚北, 等. 胫腓骨开放骨折Taylor空间支架外固定术后轴向应力刺激对骨折愈合的影响研究. 中国修复重建外科杂志, 2017, 31(8): 931-935.
10.	李公伦, 王国蕊, 韩锐华, 等. 多功能外固定支架治疗四肢严重开放性骨折病例报道. 生物骨科材料与临床研究, 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.	马继海, 张涛, 海碧霞, 等. 骨外固定动力化治疗开放性胫腓骨骨折. 中国修复重建外科杂志, 2018, 32(2): 174-177.
13.	张利献, 席学义, 张文献. 骨折后局部血肿对骨痂形成的意义. 中华实用医药杂志, 2005, 5(8): 557.
14.	曾宪铁, 庞贵根, 王宏川, 等. 闭合复位经皮插入锁定加压钢板技术在胫骨远端骨折的应用. 中国矫形外科杂志, 2008, 16(20): 1584-1585.
15.	张英泽, 韩志杰, 刘欢, 等. 河北医科大学第三医院骨折治疗理念与原则. 河北医科大学学报, 2017, 38(9): 1093-1095.
16.	刘彦士, 马信龙, 万春友, 等. 计算机辅助测量在Taylor外固定支架治疗胫腓骨骨折中的应用. 中国矫形外科杂志, 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. 卢庆威, 万春友, 张弢, 等. 轴向载荷力学测试在胫腓骨骨折术后外固定器拆除中的临床应用. 中国修复重建外科杂志, 2016, 30(9): 1085-1088.
4. 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.
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. 王德龙, 刘志成. 家兔骨延长术中固定刚度对骨愈合的影响. 北京生物医学工程, 2017, 36(5): 488-494.
8. 夏和桃. 外固定器刚度对骨折愈合的影响. 中华创伤骨科杂志, 2007, 9(12): 1170-1172.
9. 葛启航, 万春友, 刘亚北, 等. 胫腓骨开放骨折Taylor空间支架外固定术后轴向应力刺激对骨折愈合的影响研究. 中国修复重建外科杂志, 2017, 31(8): 931-935.
10. 李公伦, 王国蕊, 韩锐华, 等. 多功能外固定支架治疗四肢严重开放性骨折病例报道. 生物骨科材料与临床研究, 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. 马继海, 张涛, 海碧霞, 等. 骨外固定动力化治疗开放性胫腓骨骨折. 中国修复重建外科杂志, 2018, 32(2): 174-177.
13. 张利献, 席学义, 张文献. 骨折后局部血肿对骨痂形成的意义. 中华实用医药杂志, 2005, 5(8): 557.
14. 曾宪铁, 庞贵根, 王宏川, 等. 闭合复位经皮插入锁定加压钢板技术在胫骨远端骨折的应用. 中国矫形外科杂志, 2008, 16(20): 1584-1585.
15. 张英泽, 韩志杰, 刘欢, 等. 河北医科大学第三医院骨折治疗理念与原则. 河北医科大学学报, 2017, 38(9): 1093-1095.
16. 刘彦士, 马信龙, 万春友, 等. 计算机辅助测量在Taylor外固定支架治疗胫腓骨骨折中的应用. 中国矫形外科杂志, 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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