Ankle arthrodesis using the Taylor Spatial Frame for the treatment of infection, extruded talus and complex pilon fractures

Ordas-Bayon, Alejandro; Logan, Karl; Garg, Parag; Peat, Fidel; Krkovič, Matija

doi:10.1016/j.injury.2021.02.003

Cited by 11 publications

(36 citation statements)

References 45 publications

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“…b X-rays after surgery. c X-rays after the first correction deformity correction process, the hexapod external fixator expanded its use in fracture and bone nonunion treatment [11,12,[18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Staged correction trajectory with hexapod external fixator for the satisfactory reduction of long bone shaft fracture

Liu

Wang

et al. 2022

BMC Musculoskelet Disord

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Backgroud When the reduction of long bone shaft fracture fragments is performed by a hexapod external fixator, the collision and interference between bony ends often results in an incomplete reduction and a time-consuming procedure. The purpose of this study was to present and determine the clinical effectiveness of staged correction trajectory with hexapod external fixator in the reduction of a long bone shaft fracture. Methods A total of 57 patients with tibial shaft fractures treated by hexapod external fixator were retrospectively analyzed from June 2016 to February 2020. Thirty-one cases (Group I) underwent a conventional one-step reduction trajectory from June 2016 to July 2018. Starting in September 2018, the other twenty-six patients (Group II) underwent staged correction trajectory (three key points reduction trajectory of “distraction-derotation-reduction”). The demographic data, residual deformities before and after correction, number of repeated X-rays after the first postoperative X-ray, duration of deformity correction process, and external fixation time were analyzed. Johner-Wruhs criteria were used to evaluate the final clinical outcomes. Results All the 57 patients achieved satisfactory fracture reduction and bone union. There were no significant differences between the two groups in demographic data, residual deformities before and after correction, external fixation time, and final clinical outcomes (p > 0.05). The average number of repeated X-rays after the first postoperative X-ray and mean duration of deformity correction process in Group II (1.3 times, 2.9 days) were all less than those in Group I (2.3 times, 5.1 days) (p < 0.05). Conclusion Compared with the conventional one-step reduction trajectory, there is no differences in final clinical outcomes, but the staged correction trajectory provides less repeated X-rays and shorter reduction process duration.

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Section: Discussionmentioning

confidence: 99%

Staged correction trajectory with hexapod external fixator for the satisfactory reduction of long bone shaft fracture

Liu

Wang

et al. 2022

BMC Musculoskelet Disord

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“…Second, it also provides sufficient strength to allow patients to bear weight and engage in functional exercises early, and the technology of external fixator fixation combined with bone grafting can effectively treat sizeable bone defects larger than 4 cm, thus avoiding limb shortening. At the same time, in bone transportation, skin stretching can be performed to solve the problem of soft tissue coverage [ 27 , 28 ]. On the whole, the strategy of multi-stage treatment plays an essential role in the rescue of ankle joint function.…”

Section: Discussionmentioning

confidence: 99%

Ankle joint salvage and reconstruction by limited ORIF combined with an Ilizarov external fixator for complex open tibial pilon fractures (AO 43-C3.3) with segmental bone defects

Chen

Ouyang

et al. 2022

BMC Musculoskelet Disord

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Background Open pilon fractures combined with sizeable segmental bone defects are rare, difficult to treat, and often result in the loss of ankle joint function. The purpose of this study was to determine clinical outcomes in patients with open pilon fractures and sizeable segmental bone defects treated by limited ORIF combined with an Ilizarov external fixator. Methods We conducted a retrospective analysis of open pilon fractures with sizeable segmental bone defects treated by limited ORIF combined with the Ilizarov external fixator strategy between July 2014 and August 2019. All patients were included for assessments of fracture healing and infection rates. Ankle functional outcomes were assessed in all patients according to the Paley criteria and American Orthopedic Foot and Ankle Society Score (AOFAS) at least 24 months post-injury. Results All patients were followed up for a mean of 41.09 months. The mean bone defect size was 5.64 ± 1.21 cm. The average EFI and BTI were 1.56 ± 0.28 months/cm and 11.12 ± 0.74 days/cm, respectively. According to the Paley evaluation system, the success rate of ankle joint reconstruction was 64% (7/11). The mean score based on the AOFAS functional assessment was 77.73 ± 8.87. Five patients showed posttraumatic arthritis, one of whom required ankle arthrodesis. Three patients developed pin site infections, and one patient developed a deep infection after bone grafting. Conclusion The strategy of limited ORIF combined with an Ilizarov external fixator can restore ankle function in most patients with complex open tibial pilon fractures. Ankle stiffness, pin tract infection, and traumatic arthritis were the most common complications associated with this therapy.

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“…Combined with the Ilizarov circular external xator and the Chasles theorem of six-axis motion 15,16 , the hexapod external xator has played an important role in orthopedic and reconstructive surgery due to the advantages of simultaneous correction of multiplanar spatial deformities without frame modi cation 4,7,8,10,12,[17][18][19] . Initially developed for gradual deformity correction, the hexapod external xator expanded to conduct the management of fracture and bone nonunion 11,12,[19][20][21] .…”

Section: Discussionmentioning

confidence: 99%

Staged correction trajectory with hexapod external fixator for the satisfactory reduction of acute long bone shaft fracture

Liu

Wang

et al. 2021

Preprint

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Backgroud: When deformity correction and fracture reduction are conducted in acute long bone shaft fracture using the hexapod external fixator, the collision and interference between the irregular bony end in the reduction process often result in an incomplete reduction and a time-consuming procedure. The purpose of this study was to present and determine the clinical effectiveness of staged correction trajectory with hexapod external fixator for the satisfactory reduction of acute long bone shaft fracture. Methods A total of 57 patients with acute tibial shaft fractures consented to hexapod external fixator treatment in our institution were retrospectively analyzed from June 2016 to February 2020. Thirty-one cases (Group Ⅰ) underwent a conventional one-step reduction trajectory from June 2016 to July 2018. Starting in September 2018, the other twenty-six patients (Group Ⅱ) all underwent staged correction trajectory (three key points reduction trajectory of “extension-rotation-reduction”). The demographic data, residual deformities before and after correction, number of repeated radiographs after the first postoperative radiograph, duration of deformity correction, and external fixation time were documented and analyzed. At the last clinical visit, the Johner-Wruhs criteria were used to evaluate the final clinical outcomes. Results All the 57 patients achieved satisfactory fracture reduction and bone union. There were no statistically significant differences between the two groups in demographic data, residual deformities before and after correction, external fixation time, and final clinical outcomes (P > 0.05). The average number of repeated radiographs after the first postoperative radiograph and mean duration of deformity correction in Group Ⅱ (1.3 times, 2.9 days) were all less than those in Group Ⅰ (2.3 times, 5.1 days) (P < 0.05). Conclusion Compared with the conventional one-step reduction trajectory, there are no statistically significant differences in the final clinical outcomes, but the staged correction trajectory is a superior method with the advantages of less repeated radiographs and reduction duration.

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Ankle arthrodesis using the Taylor Spatial Frame for the treatment of infection, extruded talus and complex pilon fractures

Cited by 11 publications

References 45 publications

Staged correction trajectory with hexapod external fixator for the satisfactory reduction of long bone shaft fracture

Staged correction trajectory with hexapod external fixator for the satisfactory reduction of long bone shaft fracture

Ankle joint salvage and reconstruction by limited ORIF combined with an Ilizarov external fixator for complex open tibial pilon fractures (AO 43-C3.3) with segmental bone defects

Staged correction trajectory with hexapod external fixator for the satisfactory reduction of acute long bone shaft fracture

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