Complications associated with hexapod circular fixation for acute fractures of the tibia diaphysis: A retrospective descriptive study at a high volume trauma centre

Potgieter, M; Pretorius, Henry Sean; Preez, G du; Burger, Marilize; Ferreira, Nando

doi:10.1016/j.injury.2019.11.012

Cited by 17 publications

(19 citation statements)

References 18 publications

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“…Almost all patients were able to perform daily activities without signi cant di culty. The patients in our study had an average external xation time of 25 weeks, which matches the outcomes of Francesco et al [7], Al-sayyad [31], and Potgieter et al [35]. We, therefore, acknowledge that the functional and bony outcomes of frame xation are good, especially for the complex injury.…”

Section: Discussionsupporting

confidence: 82%

“…Sala et al [34] used the TSF as a de nitive xation to treat 12 patients with shaft and distal femoral fracture, achieving good clinical and radiograph outcomes nally. Maarten et al [35] de nitively treated 102 diaphyseal fractures with hexapod circular external xation, acquiring bone union in 101 cases with an average time of 25.6 weeks. In the present study, all patients achieved bone union, therein two delayed union was successfully managed by the "accordian" technique, and one nonunion solved by autogenous iliac crest bone grafting nally.…”

Section: Discussionmentioning

confidence: 99%

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Fracture Reduction and Definitive Management for Acute Tibial Shaft Fractures Using the Taylor Spatial Frame

Liu

Yushan

et al. 2021

Preprint

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Background: The Taylor spatial frame (TSF) is increasingly used for acute tibial shaft fracture care as more general orthopedic surgeons are gaining expertise of this versatile device. The purpose of this study was to evaluate the clinical effectiveness of the TSF for fracture reduction and definitive management in patients with acute tibial shaft fractures.Methods: The study was conducted on 34 patients with acute tibial shaft fractures who were admitted or referred to our institution and consented to TSF treatment from Jan 2016 to June 2019, including 27males and 7 females with a mean age of 39 years (range 18 to 65 years). Patients' clinical and radiological data, and the final clinical outcomes at a minimum of 12 months follow-up were collected and retrospectively analyzed. All complications were documented according to Paley’s classification. The clinical outcomes were evaluated using the Association for the Study and Application of the Method of Ilizarov criteria (ASAMI) at the last clinical visit.Results: All patients remained in the TSF for a mean of 26 weeks (range 15 to 52 weeks) and acquired complete bone union. The satisfactory alignment was achieved in all patients, and all the patients were able to perform daily activities with no difficulty at the last clinical visit. Complications included pin tract infection (44%), delayed union (6%), nonunion (3%), and joint stiffness (3%). The ASAMI bony result was excellent in 31 patients and good in 3. The ASAMI functional result was excellent in 27 patients, good in 6, and fair in 1. Conclusions: Fracture reduction and definitive management using the Taylor spatial frame is an alternative and effective method for acute tibial shaft fractures, including technical advantages of early trauma-control, ease of soft tissue care, the versatility of achieving excellent alignment, and the continuity of device until bone union.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Fracture Reduction and Definitive Management for Acute Tibial Shaft Fractures Using the Taylor Spatial Frame

Liu

Yushan

et al. 2021

Preprint

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“…Although intramedullary nail is the gold standard in the management of tibial diaphyseal fractures, external xation has a clear role in most cases due to the advantage of stabilization with limiting soft tissue dissection, especially for high-energy injuries with poor surrounding soft tissues 3,4,6,8,10,14,17,21 .…”

Section: Discussionmentioning

confidence: 99%

“…The current study reported a group of 53 high-energy tibial diaphyseal fractures treated by HEF or MEF. Several complications in external xation treatment, such as pin tract infection, loss of reduction, delayed union, nonunion, and joint stiffness, have been well reported 4,10,28 . In reviewing our data, pin tract infection was the most common complication, as expected.…”

Section: Discussionmentioning

confidence: 99%

“…External xators have played a crucial and effective role in fracture cases with poor surrounding soft tissues due to the capability of fracture stabilization with minimal soft tissue disruption and early weightbearing 8,9 . The hexapod external xator (HEF), which was initially developed to address multiplanar deformities, consisting of two rings or partial rings connected by six telescopic struts at special universal joints, has become an attractive option in the management of high-energy fractures 5,[10][11][12][13][14] . The HEF simpli es the intraoperative reduction procedures and shortens the operation duration, allowing the treating surgeons to achieve postoperative accurate fracture reduction without frame modi cation.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes in the Definitive Treatment of High-energy Tibial Diaphyseal Fractures using Hexapod External Fixator Versus Monolateral External Fixator

Liu¹,

Liu²,

Cai³

et al. 2021

Preprint

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Background: External fixation, which can preserve the biomechanical microenvironment of fracture healing, playing an important role in managing the high-energy fractures with poor surrounding soft tissues. The purpose of this study was to determine the differences of clinical outcomes, if any, between hexapod external fixator and monolateral external fixator in the definitive treatment of high-energy tibial diaphyseal fractures.Methods: A total of 53 patients with high-energy tibial diaphyseal fractures and definitively treated by the hexapod external fixator (HEF) or monolateral external fixator (MEF) were retrospectively collected and analyzed, from March 2015 to June 2019. There were 31 patients in the HEF treatment, and the other 22 patients were managed by the MEF. The demographic data, surgical duration, external fixation time, final radiological results, complications, and clinical outcomes were documented and analyzed. Difficulties that occur during the treatment were classified according to Paley. The clinical outcomes were evaluated by the Association for the Study and Application of the Method of Ilizarov criteria (ASAMI) at the last clinical visit.Results: The mean surgical duration in the HEF group (62.4±8.3 minutes) was shorter than that in the MEF group (91.4±6.9 minutes) (P<0.05). All patients acquired complete bone union finally. Patients in the HEF group (24.2±3.1 weeks) underwent a shorter average external fixation time than that in the MEF group (26.3±3.8 weeks) (P<0.05). Satisfactory alignment was achieved in all patients without the need for remanipulation. The residual sagittal plane deformities in the HEF group were all less than that in the MEF group (P<0.05). The complication rate was 35.5% in the HEF group, while 45.5% in the MEF group. There was no statistically significant difference between the two groups in ASAMI scores (P>0.05).Conclusion: There is no statistically significant difference in finally clinical outcomes between hexapod external fixator and monolateral external fixator in the definitive treatment of high-energy tibial diaphyseal fractures. The hexapod external fixation treatment is a superior effective method, including advantages of stable fixation, less surgical duration, postoperatively satisfactory fracture reduction, and fewer complications.

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Definitive Taylor Spatial Frame management for the treatment of high-energy open tibial fractures: Clinical and patient-reported outcomes

Tucker¹,

Norrish²,

Fendius³

et al. 2022

Injury

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Complications associated with hexapod circular fixation for acute fractures of the tibia diaphysis: A retrospective descriptive study at a high volume trauma centre

Cited by 17 publications

References 18 publications

Fracture Reduction and Definitive Management for Acute Tibial Shaft Fractures Using the Taylor Spatial Frame

Fracture Reduction and Definitive Management for Acute Tibial Shaft Fractures Using the Taylor Spatial Frame

Clinical Outcomes in the Definitive Treatment of High-energy Tibial Diaphyseal Fractures using Hexapod External Fixator Versus Monolateral External Fixator

Definitive Taylor Spatial Frame management for the treatment of high-energy open tibial fractures: Clinical and patient-reported outcomes

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