Functional outcomes of the failed plate fixation in distal tibial fractures salvaged by hexapod external fixator

被引：6
作者：
Molepo M. [1 ]
Barnard A.-C. [2 ]
Birkholtz F. [1 ,2 ]
Tetsworth K. [3 ,4 ,5 ,6 ]
Glatt V. [6 ,7 ]
Hohmann E. [8 ,9 ]
机构：
[1] Department of Orthopaedic Surgery, University of Pretoria, Pretoria
[2] Walk-A-Mile Centre for Advanced Orthopaedics, Centurion, Pretoria
[3] Department of Orthopaedic Surgery, Royal Brisbane Hospital, Brisbane
[4] Department of Surgery, School of Medicine, University of Queensland, Brisbane
[5] Queensland University of Technology, Brisbane
[6] Orthopaedic Research Centre of Australia, Brisbane
[7] University of Texas Health Science Center, San Antonio, Tx
[8] School of Medicine, University of Pretoria, Pretoria
[9] Department of Orthopaedic Surgery and Sports Medicine, Valiant Clinic/Houston Methodist Group, PO Box 414296, Dubai
来源：
European Journal of Orthopaedic Surgery & Traumatology | 2018年 / 28卷 / 8期
关键词：
Circular external fixation; Distal tibial fractures; Hexapod; Non-union; Plate fixation;
D O I：
10.1007/s00590-018-2231-x
中图分类号：
学科分类号：
摘要：
Purpose: The purpose of this study was to evaluate the clinical and functional outcomes of failed plate fixation in distal tibia fractures salvaged with hexapod circular fixators. Materials and methods: The database of a specialized limb reconstruction center was searched for all patients with failed plate fixation undergoing limb reconstruction with a circular external fixator between 2008 and 2017. Patients between the ages of 18–65 years, with a symptomatic distal tibia malunion or non-union following plate and screw fixation were included. The SF-12 and Foot Function Index (FFI) scoring systems were used to measure clinical and functional outcomes. Results: Ten patients with a mean age of 38 ± 13 years met the inclusion criteria. Seven patients had an infected non-union, two hypertrophic non-unions, and one a malunion. The mean follow-up was 41.7 ± 28.3 months. The mean duration of external fixation was 232.9 ± 146.6 days. The SF-12 demonstrated a mean score of 49.4 ± 7.7 for the physical component and a mean score of 55.3 ± 8.1 for the mental component. Five patients (50%) scored above 45 points for the SF12 physical component, and nine patients (90%) scored above 45 points for the mental component, indicating good outcome can be achieved. The mean FFI score was 24.9 ± 19.9, and six patients had a score below 14 points (good outcome). Radiological union was observed in all 10 patients at a mean of 29 ± 14 months. Conclusions: The results of this study suggest that hexapod circular external fixation is an attractive surgical alternative for the treatment of failed plate fixation of distal tibial fractures, and can reliably achieve bony union and result in very satisfactory clinical outcomes. Level of Evidence: Level IV case series. © 2018, Springer-Verlag France SAS, part of Springer Nature.
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页码：1617 / 1624
页数：7
相关论文
共 35 条
  • [1] Sirkin M., Sanders R., The treatment of pilon fractures, Orthop Clin North Am, 32, pp. 91-102, (2001)
  • [2] Zelle B.A., Bhandari M., Espiritu M., Koval K.J., Zlowodzki M., Treatment of distal tibia fractures without articular involvement: a systematic review of 1125 fractures, J Orthop Trauma, 20, pp. 76-79, (2006)
  • [3] Gao H., Zhang C.Q., Luo C.F., Zhou Z.B., Zeng B.F., Fractures of the distal tibia treated with polyaxial locking plating, Clin Orthop Relat Res, 467, pp. 831-837, (2009)
  • [4] Bozkurt M., Ocquder D.A., Uguru M., Kalkan T., Tibial Pilon Fracture repair using Ilizarov External Fixation, Capsuloligamentotaxis and early Rehabilitation of the ankle, J Foot Ankle Surg, 47, 4, pp. 302-306, (2008)
  • [5] Joveniaux P., Ohl X., Harisboure A., Berrichi A., Labatut L., Simon P., Et al., Distal tibia fractures: management and complications of 101 cases, Int Orthop, 34, pp. 583-588, (2010)
  • [6] Antonova E., Le Burge T.K.R., Mershon J., Tibia shaft fractures: costly burden of nonunions, BMC Musculoskeletal Disord, 14, (2013)
  • [7] Vallier H.A., Cureton B.A., Patterson B.M., Randomized, prospective comparison of plate versus intramedullary nail fixation for distal tibia shaft fractures, J Orthop Trauma, 25, pp. 736-741, (2011)
  • [8] Barcak E., Collinge C.A., Metaphyseal distal tibia fractures: a cohort, single-surgeon study comparing outcomes of patients treated with minimally invasive plating versus intramedullary nailing, J Orthop Trauma, 30, 5, pp. 169-174, (2016)
  • [9] Eralp I.L., Kocaoglu M., Goksel D., Azam M.E., Balci H.I., Bilen E., Treatment of infected non-unions of the juxta-articular region of distal tibia, Acta Orthop Traumatol Turc, 50, 2, pp. 139-146, (2016)
  • [10] Richard R.D., Kubiak E., Horwitz D.S., Techniques for the surgical treatment of distal tibia fractures, Orthop Clin N Am, 45, pp. 295-312, (2014)
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