Clinical and Functional Outcomes in Patients with Distal Tibial Fracture Treated by Circular External Fixation: A Retrospective Cohort Study.

IF 1 Q3 ORTHOPEDICS
Vasileios P Giannoudis, Emma Ewins, D Martin Taylor, Patrick Foster, Paul Harwood
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引用次数: 4

Abstract

Aims and objectives: To examine clinical and functional outcomes in patients with intra- and extra-articular distal tibial fractures treated definitively by Ilizarov fixation.

Materials and methods: Patients with tibial fractures extending within 1 Müller square of the ankle joint were identified from our Ilizarov database over a 5-year period. Data on treatment and outcome were assembled from this database and supplemented by a review of patient records. General measures of health-related quality of life and limb-specific functional outcome scores were recorded. Adverse events were documented according to Paley's classification.

Results: One hundred and sixty-eight patients with 169 fractures were identified, 28% were open and 63% intra-articular. One hundred and sixty-five (98%) of the fractures united, two following bone grafting in their original frames, at a median of 166.5 days (range 104-537). Three patients with nonunions united with further treatment. One patient (an end-stage diabetic) elected to undergo amputation following multiple early complications during treatment. Closed fractures united more rapidly than open (median 157 vs 183 days; p = 0.005) and true Pilon (43C3) fractures took longer to unite than other fractures (median 157 vs 177 days; p = 0.01).Sixty-seven percent of patients completed functional outcome scores. Sixty-two percent reported good or excellent ankle scores at more than 6 months post frame removal, 38% fair and 10% poor. Patients with intra-articular fractures reported significantly worse ankle scores than those with extra-articular injuries. General measures of health-related quality of life (EuroQol-5D) revealed significant ongoing effects despite good clinical outcomes.

Conclusion: This study demonstrates a high union and low serious complication rate, suggesting that external ring fixation is a safe and effective treatment for these injuries.

How to cite this article: Giannoudis VP, Ewins E, Taylor DM, et al. Clinical and Functional Outcomes in Patients with Distal Tibial Fracture Treated by Circular External Fixation: A Retrospective Cohort Study. Strategies Trauma Limb Reconstr 2021;16(2):86-95.

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环形外固定治疗胫骨远端骨折患者的临床和功能结果:一项回顾性队列研究。
目的和目的:检查Ilizarov内固定治疗关节内和关节外胫骨远端骨折患者的临床和功能结果。材料和方法:从我们的Ilizarov数据库中确定了5年内延伸至踝关节1 Müller方范围内的胫骨骨折患者。有关治疗和结果的数据来自该数据库,并通过对患者记录的审查进行补充。记录健康相关生活质量的一般测量和肢体特定功能结果评分。根据Paley分类记录不良事件。结果:168例患者共169处骨折,其中28%为开放性骨折,63%为关节内骨折。一百六十五(98%)的骨折愈合,其中两处在原始框架内进行骨移植后愈合,平均时间为166.5天(范围104-537)。3例骨不连患者联合治疗。一名患者(终末期糖尿病患者)在治疗过程中出现多种早期并发症,选择截肢。闭合性骨折比开放性骨折愈合更快(中位数157天vs 183天;p=0.005),真正的Pilon(43C3)骨折比其他骨折愈合时间更长(中位数157天vs 177天;p=0.01)。67%的患者完成了功能结果评分。62%的患者在框架移除后6个月以上报告脚踝得分良好或优秀,38%尚可,10%较差。关节内骨折患者的踝关节评分明显低于关节外损伤患者。健康相关生活质量的一般测量(EuroQol-5D)显示,尽管临床结果良好,但仍有显著的持续影响。结论:本研究显示了高愈合率和低严重并发症发生率,表明外环固定是一种安全有效的治疗这些损伤的方法。如何引用这篇文章:Giannoudis VP,Ewins E,Taylor DM等。环形外固定治疗胫骨远端骨折患者的临床和功能结果:回顾性队列研究。创伤肢体康复策略2021;16(2):86-95。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Strategies in Trauma and Limb Reconstruction
Strategies in Trauma and Limb Reconstruction Medicine-Orthopedics and Sports Medicine
CiteScore
1.50
自引率
0.00%
发文量
31
期刊介绍: Strategies in Trauma and Limb Reconstruction is dedicated to surgeons, allied medical professionals and researchers in the field of orthopaedics and trauma. The scope of the journal is to discuss the fields of skeletal injury, and the complications thereof, congenital and acquired limb deformities and deficiencies, and orthopaedic-related infection, together with their surgical and non-surgical treatments. The journal publishes original articles, reviews, case reports, descriptions of new or recognised treatment techniques, forum discussions of clinical scenarios and relevant correspondence. It aims to provide a widely accessible source of useful information to practitioners in the field through the problem- or technique-based approach of published articles.
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