Radiological and Functional Outcomes of Joshi External Stabilization System (JESS) in Proximal Tibia Fractures: A Case Series.

IF 1.3 4区医学 Q3 ORTHOPEDICS

Indian Journal of Orthopaedics Pub Date : 2026-07-10 eCollection Date: 2026-10-01 DOI:10.1007/s43465-026-01887-y

Siddhartha Sinha, Sandeep Kumar, Arvind Kumar, Saket Bandil, Owais Ahmed Qureshi, Javed Jameel

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引用次数: 0

Abstract

Introduction: External fixators have a limited role in the management of tibial plateau fractures (TPF). They are typically used as an initial management strategy. The Joshi External Stabilisation System (JESS) is a Kirschner wire-based fixator and has been used in TPF where plating may not be feasible due to poor skin conditions or delayed due to other soft tissue complications. This retrospective case series aimed to evaluate the radiological and functional outcomes of TPF managed using the JESS fixator.

Materials and methods: Records of patients operated on with the JESS fixator for TPF between January 2021 and January 2024 were included in the case series. Data for each follow up at 2 weeks, 6 weeks, 12 weeks and 24 weeks was retrospectively collected. Demographic data, fracture classification using the Schatzker and Gustilo-Anderson and assessment of clinical, radiological union and complications on each follow-up were collected. The Knee Society Score (KSS) and visual analogue scale (VAS) were used for functional assessment of the patients.

Results: Twenty-three patients were included, with an average age of 41 ± 11.18 years. The majority of injuries were due to road traffic accidents (69.6%) and were mostly closed fractures (73.9%). Schatzker type VI injuries were the most common (39.13%). The mean time from injury to surgery was 6.04 ± 2.6 days. Bridging callus was noted in all patients at 6 weeks follow up and complete union was noted in all patients by 14 weeks. VAS scores improved significantly with each follow-up. The KSS increased from 27.8 ± 15.7 at 2 weeks to 83.6 ± 7.5 at 24 weeks. The complication rate was 17.4%, with pin site infection being the most common (13%).

Conclusion: The JESS is a useful option in high energy fractures with compromised soft tissues consistent with the principles of damage-control orthopaedics for the management of TPF. It offers good functional outcomes with a relatively low complication rate where plating may not be feasible as an early management. More studies with higher levels of evidence are required for validation of the results of this study.

Level of evidence: Level IV.

Supplementary information: The online version contains supplementary material available at https://doi.org/10.1007/s43465-026-01887-y.

查看原文本刊更多论文

Joshi外固定系统（JESS）治疗胫骨近端骨折的放射学和功能结果：一个病例系列。

外固定架在胫骨平台骨折（TPF）治疗中的作用有限。它们通常被用作初始管理策略。Joshi外部稳定系统（JESS）是一种基于克氏针的固定器，用于因皮肤状况不佳或因其他软组织并发症而延迟电镀可能无法进行的TPF。本回顾性病例系列旨在评估使用JESS固定器治疗TPF的放射学和功能结果。材料和方法：病例系列纳入2021年1月至2024年1月期间使用JESS固定器进行TPF手术的患者记录。回顾性收集每次随访2周、6周、12周和24周的数据。收集人口统计学数据，采用Schatzker和Gustilo-Anderson进行骨折分类，并评估每次随访的临床、放射学愈合和并发症。采用膝关节社会评分（KSS）和视觉模拟评分（VAS）对患者进行功能评估。结果：入选患者23例，平均年龄41±11.18岁。以道路交通事故为主（69.6%），以闭合性骨折为主（73.9%）。Schatzker VI型损伤最为常见（39.13%）。从损伤到手术的平均时间为6.04±2.6天。所有患者在随访6周时均出现桥接性骨痂，14周时均出现完全愈合。VAS评分在每次随访中均有显著改善。KSS由2周时的27.8±15.7增加到24周时的83.6±7.5。并发症发生率为17.4%，以针部感染最为常见（13%）。结论：JESS是高能骨折伴软组织受损的有效选择，符合损伤控制骨科治疗TPF的原则。它提供了良好的功能结果，并发症发生率相对较低，电镀可能不可行作为早期治疗。需要更多的研究和更高水平的证据来验证本研究的结果。证据级别：四级。补充信息：在线版本包含补充材料，可在https://doi.org/10.1007/s43465-026-01887-y上获得。

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来源期刊

Indian Journal of Orthopaedics ORTHOPEDICS-

CiteScore

1.80

自引率

0.00%

发文量

185

审稿时长

9 months

期刊介绍： IJO welcomes articles that contribute to Orthopaedic knowledge from India and overseas. We publish articles dealing with clinical orthopaedics and basic research in orthopaedic surgery. Articles are accepted only for exclusive publication in the Indian Journal of Orthopaedics. Previously published articles, articles which are in peer-reviewed electronic publications in other journals, are not accepted by the Journal. Published articles and illustrations become the property of the Journal. The copyright remains with the journal. Studies must be carried out in accordance with World Medical Association Declaration of Helsinki.