Comparative Analysis of Complication Rates in Tibial Shaft Fractures: Intramedullary Nail vs. Ilizarov External Fixation Method

IF 4.7 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC

ACS Applied Electronic Materials Pub Date : 2024-03-31 DOI:10.3390/jcm13072034

Danilo Jeremić, Nikola Grubor, Zoran Bascarevic, N. Slavkovic, B. Krivokapic, B. Vukomanović, Kristina Davidovic, Želimir Jovanović, Slavko Tomić

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引用次数: 0

Abstract

Background: The external fixation (EF) Ilizarov method, shown to offer efficacy and relative safety, has unique biomechanical properties. Intramedullary nail fixation (IMN) is an advantageous alternative, offering biomechanical stability and a minimally invasive procedure. The aim of this study was to assess outcomes in patients undergoing tibia fracture fixation, comparing the Ilizarov EF and IMN methods in an early phase of IMN implementation in Serbia. Methods: This was a retrospective study including patients with radiologically confirmed closed and open (Gustilo and Anderson type I) tibial diaphysis fractures treated at the Institute for Orthopedic Surgery “Banjica’’ from January 2013 to June 2017. The following demographic and clinical data were retrieved: age, sex, chronic disease diagnoses, length of hospital stay, surgical wait times, surgery length, type of anesthesia used, fracture, prophylaxis, mechanism of injury, postsurgical complications, time to recovery, and pain reduction. Pain intensity was measured by the Visual Analog Scale (VAS), a self-reported scale ranging from 0 to 100 mm. Results: A total of 58 IMN patients were compared to 74 patients who underwent Ilizarov EF. Study groups differed in time to recovery (p < 0.001), length of hospitalization (p = 0.007), pain intensity at the fracture site (p < 0.001), and frequency of general anesthesia in favor of intramedullary fixation (p < 0.001). A shorter surgery time (p < 0.001) and less antibiotic use (p < 0.001) were observed when EF was used. Additionally, we identified that the intramedullary fixation was a significant predictor of pain intensity. Conclusions: The IMN method offers faster recovery and reduced pain intensity in comparison to EF, while the length of surgery predicted the occurrence of any complication.

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胫骨轴骨折并发症发生率的比较分析：髓内钉与伊利扎罗夫外固定法比较

背景：伊利扎洛夫外固定（EF）方法具有疗效和相对安全性，但它具有独特的生物力学特性。髓内钉固定（IMN）是一种具有生物力学稳定性和微创手术优势的替代方法。本研究旨在评估接受胫骨骨折固定术的患者的疗效，并在塞尔维亚实施髓内钉固定术的早期阶段比较 Ilizarov EF 和 IMN 方法。方法：这是一项回顾性研究，包括2013年1月至2017年6月期间在 "Banjica''骨科研究所接受治疗的经放射学证实的闭合性和开放性（Gustilo和Anderson I型）胫骨干骺端骨折患者。研究人员检索了以下人口统计学和临床数据：年龄、性别、慢性疾病诊断、住院时间、手术等待时间、手术时间、使用的麻醉类型、骨折情况、预防措施、损伤机制、术后并发症、恢复时间和疼痛减轻情况。疼痛强度采用视觉模拟量表（VAS）进行测量，这是一种自我报告的量表，范围从 0 到 100 毫米。结果共有 58 名 IMN 患者与 74 名接受 Ilizarov EF 的患者进行了比较。研究组在恢复时间（p < 0.001）、住院时间（p = 0.007）、骨折部位疼痛强度（p < 0.001）和全身麻醉频率方面存在差异，髓内固定术更胜一筹（p < 0.001）。使用 EF 时，手术时间更短（p < 0.001），抗生素用量更少（p < 0.001）。此外，我们还发现髓内固定是疼痛强度的重要预测因素。结论：与 EF 相比，IMN 方法恢复更快，疼痛强度更低，而手术时间的长短则预示着并发症的发生。

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来源期刊

ACS Applied Electronic Materials Multiple-

CiteScore

7.20

自引率

4.30%

发文量

567

期刊介绍： ACS Applied Electronic Materials is an interdisciplinary journal publishing original research covering all aspects of electronic materials. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials science, engineering, optics, physics, and chemistry into important applications of electronic materials. Sample research topics that span the journal's scope are inorganic, organic, ionic and polymeric materials with properties that include conducting, semiconducting, superconducting, insulating, dielectric, magnetic, optoelectronic, piezoelectric, ferroelectric and thermoelectric. Indexed/Abstracted： Web of Science SCIE Scopus CAS INSPEC Portico