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.
ObjectiveTo explore the effectiveness of Taylor spatial frame (TSF) in the treatment of tibiofibular fractures and computer-assisted closed reduction.MethodsThe 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.ResultsBoth 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).ConclusionCompared 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.
ObjectiveTo explore the safety and effectiveness of Taylor spatial frame (TSF) in the treatment of medial compartmental osteoarthritis (MCOA) of the knee and the adjustment of the lower extremity force line at the same time.MethodsThe clinical data of 30 patients with MCOA who underwent high tibial osteotomy (HTO) between October 2016 and April 2017 were retrospectively analyzed. According to the different fixation methods, they were divided into external fixation group (TSF external fixation, 16 cases) and internal fixation group (locking steel plate internal fixation, 14 cases). There was no significant difference between the two groups in gender, age, side, disease duration, mechanical femur tibia angle (MFTA), and other general data (P>0.05). The operation time and intraoperative blood loss of the two groups were recorded and compared; MFTA was used to evaluate the recovery of the lower extremity force line at last follow-up; Hospital for Special Surgery (HSS) score was used to evaluate the clinical effecacy before operation and at 2 weeks, 1 month, and 3 months after operation.ResultsThe operation time and intraoperative blood loss of external fixation group were significantly less than those of internal fixation group (P<0.05). All patients were followed up 9-16 months, with an average of 12 months. There were 2 cases of delayed healing in the internal fixation group and 1 case of delayed healing in the external fixation group, and all healed after symptomatic treatment. All patients in the two groups had no complication such as needle infection, nonunion at osteotomy, osteomyelitis, and so on. At last follow-up, MFTA standard was used to evaluate the recovery of force line. The results of external fixation group were all excellent, while the results of internal fixation group were excellent in 10 cases and good in 4 cases. The difference between the two groups was significant (Z=–2.258, P=0.024). The HSS scores in the two groups were significantly improved at each time point after operation, and gradually improved with time after operation (P<0.05). The HSS score of the external fixation group was significantly higher than that of the internal fixation group (t=2.425, P=0.022) at 3 months after operation; and there was no significant difference between the two groups at other time points (P>0.05).ConclusionTSF has unique advantages in HTO treatment of MCOA patients and correction of lower extremity force line, such as shorter operation time, less bleeding, firm fixation, and less complications. It can accurately adjust the lower extremity force line after operation and has good effectiveness. It is an effective and safe fixation method.
ObjectiveTo compare the effectiveness of Taylor spatial frame (TSF) and unilateral external fixator in the treatment of tibiofibular open fractures.MethodsBetween 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.ResultsAll 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).ConclusionFor 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.