Circular external fixation and cemented PMMA spacers for the treatment of complex tibial fractures and infected nonunions with segmental bone loss

Niekerk, Andries H van; Birkholtz, Franz; Lange, P de; Tetsworth, Kevin; Hohmann, Erik

doi:10.1177/2309499017716242

Cited by 32 publications

(23 citation statements)

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“…Ultimately, 11 studies met the inclusion and exclusion criteria in our systematic review [ 14 – 24 ]. Of the included studies, 6 studies were retrospective case series [ 15 , 18 – 20 , 22 , 23 ], 4 researches were retrospective comparative studies [ 14 , 17 , 21 , 24 ], and 1 study was a prospective case series [ 16 ]. The quality of the included studies using a modified Newcastle-Ottawa scale (score range, 0-7) ranged from 5 to 7, with 5 positive answers taken to define a good quality study.…”

Section: Resultsmentioning

confidence: 99%

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A Systematic Review and Meta-Analysis of Combined Antibiotic Spacer with Ilizarov Methods in the Treatment of Infected Nonunion of Tibia

Deng

Sun

et al. 2021

BioMed Research International

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Background. The objective of this systematic review was to evaluate current studies available reporting the antibiotic spacer combined with Ilizarov methods in the treatment of infected nonunion of tibia and to perform meta-analysis of bone results and infection recurrence to assess the efficacy of an antibiotic spacer combined with Ilizarov methods. Methods. The MEDLINE, Embase, Cochrane Library, CNKI, and CBM (Chinese Biological Medicine) databases were searched for articles published between January 2000 and July 2020. Assessment of study quality was performed using a modified version of the Newcastle-Ottawa scale. Effect size and 95% confidence intervals were calculated for the main outcome. Heterogeneity was assessed. Fixed-effect modeling and Stata version 15.1 were used to analyze the data. Sensitivity analyses were conducted with the evidence of heterogeneity. Results. 11 studies involving 210 patients with infected nonunion of tibia were finally included in our meta-analysis. Bone results and infection recurrence were analyzed based on the single-arm meta-analysis. The average of external fixation index (EFI) was 46.88 days/cm in all studies included. The excellent rate in bone results and the rate of infection recurrence was 65% (95% CI: [0.22, 0.97], I 2 = 0.0 % , P = 0.932 ) and 6.99% (95% CI: [0.052, 0.325], I 2 = 0.0 % , P = 1.000 ) in patients with infected nonunion of tibia treated with an antibiotic spacer combined with Ilizarov methods. Conclusions. Our meta-analysis revealed that the patients with infected nonunion of tibia treated with an antibiotic spacer combined with Ilizarov methods had a high rate of excellent bone results and a low rate of infection recurrence. Therefore, combining the antibiotic spacer with Ilizarov methods may be an applicable choice for repairing and reconstructing infected nonunion of tibia.

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Section: Resultsmentioning

confidence: 99%

“…Bone grafting as a routine treatment was recommended at the end of the bone transport in 2 included studies [ 16 , 17 ]. Suturing the induced membrane produced by the antibiotic spacer was reported in 3 included studies [ 18 , 20 , 21 ].…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of Combined Antibiotic Spacer with Ilizarov Methods in the Treatment of Infected Nonunion of Tibia

Deng

Sun

et al. 2021

BioMed Research International

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“…Nadir uygulanan bu tedavi yöntemlerinin dezavantajları arasında; kaynamama ve enfeksiyon oranlarındaki yükseklik, ekstremite diziliminin ve uzunluğunun sağlanmasındaki zorluklar, uzun tedavi süreleri, devam eden enfeksiyonlar sonucu malign dönüşümün olabilmesi ve yüksek tedavi maliyetleri sayılabilir. [1][2][3]7,[10][11][12][13][14]…”

Section: Cerrahi̇ İşlemlerunclassified

Enfekte ve/veya kemik defektli psödoartrozlarda kullanılan özel teknikler

Şen¹,

Sağlam²

2017

TOTBID

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“…Although both devices have been used in lower extremity trauma, 4 , 12 , 19 , 20 direct comparative studies have not yet been published. The purpose of this study was, therefore, to compare the functional and radiological outcomes of complex tibia fractures treated with either the TSF or the TL-HEX.…”

Section: Introductionmentioning

confidence: 99%

Outcomes Following Treatment of Complex Tibial Fractures with Circular External Fixation: A Comparison between the Taylor Spatial Frame and TrueLok-Hex

Naude¹,

Manjra²,

Birkholtz³

et al. 2020

Strategies in Trauma and Limb Reconstruction

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Aim The purpose of this study was to compare the functional and radiological outcomes of complex tibia fractures treated with two different hexapod fixators. Material and methods This is a retrospective comparative study of patients treated for complex tibial fractures between 2010 and 2015. Inclusion criteria was patients between 18 years and 60 years of age, who sustained a complex comminuted open or closed tibial fracture with or without bone loss, who had a minimum of 12 months’ follow-up, and who have been treated definitively using either Taylor Spatial Frame (TSF) or TrueLok-Hexapod System (TL-HEX). The outcome measures were Association for the Study and Application of the Method of Ilizarov (ASAMI) score, foot function index (FFI), EQ5-D, four-step square test (FSST), and timed up and go (TUG) test. Descriptive statistics were used to assess patient demographic information. Categorical variables (ASAMI and EQ5D-5L) were analysed using the χ 2 test. Continuous variables (FFI, functional tests, and radiographic outcomes) were analysed with two-tailed Student’s t tests. Results In all, 24 patients were treated with the TL-HEX and 21 with the TSF. The mean time for external fixation was 219 ± 107 days (TL-HEX) and 222 ± 98 days (TSF). Union occurred in 92% (TL-HEX) and 100% (TSF). The mean follow-up was 777 ± 278 days (TL-HEX) and 1211 ± 388 days (TSF). Using the ASAMI scores, there were 17 excellent and 6 good results for the TL-HEX and 10 excellent and 11 good results for the TSF ( p = 0.33). The FFI was 30 ± 28.7 (TL-HEX) and 26.1+23.9 (TSF) ( p = 0.55). The EQ5D was 0.67 ± 0.3 (TL-HEX) and 0.73 ± 0.2 (TSF) ( p = 0.43). The mean TUG and FSST were 9.2 ± 3.2 and 10 ± 2.9 seconds (TL-HEX) and 8.4 ± 2.3 and 9.6 ± 3.1 seconds (TSF) ( p = 0.34 and 0.69). Conclusion The results of this study suggest that both hexapod external fixation devices have comparable clinical, functional, and radiographic outcomes. Either fixator can be used for the treatment of complex tibial fractures, anticipating good and excellent clinical outcomes in approximately 80% patients. Level of evidence Therapeutic level III How to cite this article Naude J, Manjra M, Birkholtz FF, et al. Outcomes Following Treatment of Complex Tibial Fractures with Circular External Fixation: A Comparison between the Taylor Spatial Frame and TrueLok-Hex. Strategies Trauma Limb Reconstr 2019;14(3):142–147.

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Circular external fixation and cemented PMMA spacers for the treatment of complex tibial fractures and infected nonunions with segmental bone loss

Cited by 32 publications

References 40 publications

A Systematic Review and Meta-Analysis of Combined Antibiotic Spacer with Ilizarov Methods in the Treatment of Infected Nonunion of Tibia

A Systematic Review and Meta-Analysis of Combined Antibiotic Spacer with Ilizarov Methods in the Treatment of Infected Nonunion of Tibia

Enfekte ve/veya kemik defektli psödoartrozlarda kullanılan özel teknikler

Outcomes Following Treatment of Complex Tibial Fractures with Circular External Fixation: A Comparison between the Taylor Spatial Frame and TrueLok-Hex

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