伊利扎洛夫外固定法与最小内固定法的比较研究。

Murat Korkmaz, Taha Kızılkurt, Tuna Pehlivanoglu, Abdullah Kahraman, Halil Ibrahim Balci, Cengiz Sen
{"title":"伊利扎洛夫外固定法与最小内固定法的比较研究。","authors":"Murat Korkmaz, Taha Kızılkurt, Tuna Pehlivanoglu, Abdullah Kahraman, Halil Ibrahim Balci, Cengiz Sen","doi":"10.14744/tjtes.2024.25755","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Complex tibial plateau fractures present significant challenges due to severe articular comminution and soft tissue complications. There is still no consensus in the current literature regarding the optimal treatment for these fractures. This study aims to evaluate the clinical and radiological outcomes of complex tibial plateau fractures treated with Ilizarov external fixation with or without minimal internal fixation.</p><p><strong>Methods: </strong>This retrospective study analyzed 62 patients with Schatzker type V or VI tibial plateau fractures, with a minimum follow-up duration of three years. Patients were divided into two groups: one treated with circular external fixation (Ilizarov method) combined with minimal internal fixation and the other treated with circular external fixation alone. Clinical, functional, and radiological outcomes were assessed, including knee range of motion (ROM), Knee Society Score (KSS), Kujala Score, and Visual Analog Scale (VAS) score.</p><p><strong>Results: </strong>At the latest follow-up, Group 1 demonstrated better functional and clinical outcomes compared to Group 2. The mean knee range of motion in Group 1 was 116.56° versus 97.83° in Group 2 (p<0.05). Group 1 also had higher KSS scores (92.43 vs. 79.06) and Kujala Scores (94.75 vs. 90.6) and lower VAS scores (1.13 vs. 3.33) (all p<0.05). Flexion contracture and extension lag were significantly less prevalent in Group 1, with fewer cases and lower severity. Circular external fixators were removed earlier in Group 1 (120.43 days) compared to Group 2 (157.06 days) (p<0.05), with a lower incidence of delayed union in Group 1. Varus malalignment was also less frequent and less severe in Group 1. No major complications, such as neurovascular injuries, septic nonunion, or deep venous thrombosis, were reported in either group. Both groups exhibited similar rates of minor complications, primarily pin tract infections, which resolved with appropriate treatment.</p><p><strong>Conclusion: </strong>Ilizarov external fixation, with or without minimal internal fixation, is an effective treatment method for complex tibial plateau fractures. However, patients in whom the joint was anatomically reduced demonstrated better anatomical reduction, improved range of motion, earlier weight-bearing, and enhanced functional recovery, highlighting the superiority of this approach. These findings support the recommendation of this combined technique as the preferred treatment for such challenging fractures.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 2","pages":"194-201"},"PeriodicalIF":0.0000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843421/pdf/","citationCount":"0","resultStr":"{\"title\":\"Management of complex tibial plateau fractures: A comparative study of Ilizarov external fixation method with or without minimal internal fixation.\",\"authors\":\"Murat Korkmaz, Taha Kızılkurt, Tuna Pehlivanoglu, Abdullah Kahraman, Halil Ibrahim Balci, Cengiz Sen\",\"doi\":\"10.14744/tjtes.2024.25755\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Complex tibial plateau fractures present significant challenges due to severe articular comminution and soft tissue complications. There is still no consensus in the current literature regarding the optimal treatment for these fractures. This study aims to evaluate the clinical and radiological outcomes of complex tibial plateau fractures treated with Ilizarov external fixation with or without minimal internal fixation.</p><p><strong>Methods: </strong>This retrospective study analyzed 62 patients with Schatzker type V or VI tibial plateau fractures, with a minimum follow-up duration of three years. Patients were divided into two groups: one treated with circular external fixation (Ilizarov method) combined with minimal internal fixation and the other treated with circular external fixation alone. Clinical, functional, and radiological outcomes were assessed, including knee range of motion (ROM), Knee Society Score (KSS), Kujala Score, and Visual Analog Scale (VAS) score.</p><p><strong>Results: </strong>At the latest follow-up, Group 1 demonstrated better functional and clinical outcomes compared to Group 2. The mean knee range of motion in Group 1 was 116.56° versus 97.83° in Group 2 (p<0.05). Group 1 also had higher KSS scores (92.43 vs. 79.06) and Kujala Scores (94.75 vs. 90.6) and lower VAS scores (1.13 vs. 3.33) (all p<0.05). Flexion contracture and extension lag were significantly less prevalent in Group 1, with fewer cases and lower severity. Circular external fixators were removed earlier in Group 1 (120.43 days) compared to Group 2 (157.06 days) (p<0.05), with a lower incidence of delayed union in Group 1. Varus malalignment was also less frequent and less severe in Group 1. No major complications, such as neurovascular injuries, septic nonunion, or deep venous thrombosis, were reported in either group. Both groups exhibited similar rates of minor complications, primarily pin tract infections, which resolved with appropriate treatment.</p><p><strong>Conclusion: </strong>Ilizarov external fixation, with or without minimal internal fixation, is an effective treatment method for complex tibial plateau fractures. However, patients in whom the joint was anatomically reduced demonstrated better anatomical reduction, improved range of motion, earlier weight-bearing, and enhanced functional recovery, highlighting the superiority of this approach. These findings support the recommendation of this combined technique as the preferred treatment for such challenging fractures.</p>\",\"PeriodicalId\":94263,\"journal\":{\"name\":\"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES\",\"volume\":\"31 2\",\"pages\":\"194-201\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843421/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14744/tjtes.2024.25755\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14744/tjtes.2024.25755","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景:复杂的胫骨平台骨折由于严重的关节粉碎和软组织并发症而面临重大挑战。在目前的文献中,关于这些骨折的最佳治疗方法仍未达成共识。本研究旨在评估Ilizarov外固定带或不带最小内固定治疗复杂胫骨平台骨折的临床和影像学结果。方法:回顾性分析62例Schatzker V型或VI型胫骨平台骨折患者,随访时间最短为3年。患者分为两组:一组采用圆形外固定架(Ilizarov法)联合最小内固定,另一组单独采用圆形外固定架。评估临床、功能和放射学结果,包括膝关节活动范围(ROM)、膝关节社会评分(KSS)、Kujala评分和视觉模拟评分(VAS)评分。结果:在最近的随访中,组1的功能和临床效果优于组2。组1患者的平均膝关节活动范围为116.56°,组2患者为97.83°。结论:Ilizarov外固定支架,无论是否采用最小内固定,都是治疗复杂胫骨平台骨折的有效方法。然而,关节解剖复位的患者表现出更好的解剖复位、更大的活动范围、更早的负重和更强的功能恢复,突出了该入路的优越性。这些发现支持了这种联合技术作为治疗此类难治性骨折的首选方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Management of complex tibial plateau fractures: A comparative study of Ilizarov external fixation method with or without minimal internal fixation.

Background: Complex tibial plateau fractures present significant challenges due to severe articular comminution and soft tissue complications. There is still no consensus in the current literature regarding the optimal treatment for these fractures. This study aims to evaluate the clinical and radiological outcomes of complex tibial plateau fractures treated with Ilizarov external fixation with or without minimal internal fixation.

Methods: This retrospective study analyzed 62 patients with Schatzker type V or VI tibial plateau fractures, with a minimum follow-up duration of three years. Patients were divided into two groups: one treated with circular external fixation (Ilizarov method) combined with minimal internal fixation and the other treated with circular external fixation alone. Clinical, functional, and radiological outcomes were assessed, including knee range of motion (ROM), Knee Society Score (KSS), Kujala Score, and Visual Analog Scale (VAS) score.

Results: At the latest follow-up, Group 1 demonstrated better functional and clinical outcomes compared to Group 2. The mean knee range of motion in Group 1 was 116.56° versus 97.83° in Group 2 (p<0.05). Group 1 also had higher KSS scores (92.43 vs. 79.06) and Kujala Scores (94.75 vs. 90.6) and lower VAS scores (1.13 vs. 3.33) (all p<0.05). Flexion contracture and extension lag were significantly less prevalent in Group 1, with fewer cases and lower severity. Circular external fixators were removed earlier in Group 1 (120.43 days) compared to Group 2 (157.06 days) (p<0.05), with a lower incidence of delayed union in Group 1. Varus malalignment was also less frequent and less severe in Group 1. No major complications, such as neurovascular injuries, septic nonunion, or deep venous thrombosis, were reported in either group. Both groups exhibited similar rates of minor complications, primarily pin tract infections, which resolved with appropriate treatment.

Conclusion: Ilizarov external fixation, with or without minimal internal fixation, is an effective treatment method for complex tibial plateau fractures. However, patients in whom the joint was anatomically reduced demonstrated better anatomical reduction, improved range of motion, earlier weight-bearing, and enhanced functional recovery, highlighting the superiority of this approach. These findings support the recommendation of this combined technique as the preferred treatment for such challenging fractures.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信