Application of unilateral external fixation by the “joystick technique” in the treatment of pediatric tibia shaft fractures: technical note

Abstract Background The aims of current study were to present the clinical outcomes in patients with pediatric tibia shaft fractures who were treated with unilateral external fixation combined with joystick for fracture reduction and describe the details of our technique. Methods We retrospectively analyzed the patients with pediatric tibia shaft fractures who were treated with unilateral external fixation combined with joystick for fracture reduction between July 2018 and March 2020. The clinical outcomes were evaluated. Results A total of 23 patients were included in the current study with the average age of 8.0 years (ranged 4–14 years). The average duration of hospital and follow-up were 5.9 days (ranged 4–8 days) and 17.4 months (ranged 8–27 months), respectively. At postoperative 3 days, the visual analog scale (VAS) score was 3.1 ± 1.43, which was significantly lower than the preoperative score of 7.3 ± 1.5. Of these, 2 cases showed redness and swelling of pin-tract and exudation at postoperative 1 month, who improved after oral antibiotics without causing fixation failure. The average time to full weight-bearing without crutches was 5.1 weeks (ranged 3–8 weeks). All patients achieved fracture healing and good functional recovery. No complications including fixation failure, reoperation, epiphyseal injury occurred, infection around implants, vessel damage, nerve damage, and limitation of joint movement were observed. The Johner-Wruh scores showed that 21 cases (91.3%) were “excellent” and 2 cases (8.7%) were “good.” Conclusions This procedure had advantages of simple operation, minimum trauma, early recovery of lower limb function, and no risk of complications. It may provide a new choice for children with tibia shaft fractures who require surgical treatment.

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Retraction notice to “A randomised prospective study of two different combined internal and external fixation techniques for distal tibia shaft fractures” [Injury 45 (2014) 1990 - 1995]

Injury ◽

10.1016/j.injury.2015.06.031 ◽

2015 ◽

Vol 46 (8) ◽

pp. 1700

Author(s):

Liao-Jun Sun ◽

Xian-Bin Yu ◽

Cheng-Qian Dai ◽

Wei Hu ◽

Xiao-Shan Guo ◽

...

Keyword(s):

Prospective Study ◽

External Fixation ◽

Distal Tibia ◽

Shaft Fractures ◽

Tibia Shaft Fractures ◽

Fixation Techniques ◽

Retraction Notice ◽

Tibia Shaft

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EVALUATION AND COMPARISON OF OPEN AND CLOSED TIBIA SHAFT FRACTURES IN A QUATERNARY REFERENCE CENTER

Acta Ortopédica Brasileira ◽

10.1590/1413-785220182603184073 ◽

2018 ◽

Vol 26 (3) ◽

pp. 194-197 ◽

Cited By ~ 1

Author(s):

ALEX DE LIMA SANTOS ◽

CONRADO TAZIMA NITTA ◽

GUILHERME BONI ◽

GUSTAVO TADEU SANCHEZ ◽

MARCEL JUN SUGAWARA TAMAOKI ◽

...

Keyword(s):

External Fixation ◽

Readmission Rate ◽

Traffic Accidents ◽

Severe Trauma ◽

Level Of Evidence ◽

Shaft Fractures ◽

Tibia Shaft Fractures ◽

Prospective Comparative Study ◽

Hospital Stays ◽

Tibia Shaft

ABSTRACT Introduction Tibia shaft fractures are among the most common in orthopedic practice, but Brazilian literature remains limited on the subject. Objective To evaluate the characteristics of tibia shaft fractures and conduct a comparison between exposed and closed fractures of the tibia. Methods This comparative prospective study examined all tibia shaft fractures admitted to our services over a twelve-month period. The cases were evaluated according to age, trauma mechanism, sex, associated fractures, treatment, hospital stay, and readmission rate during the six months after discharge. Results Fifty-three cases met the inclusion criteria. The average age was 36 years (SD 14.3) and 83% were males (p<0.001). Traffic accidents were responsible for 73.6% of fractures (p<0.001). Exposed fractures were found in 52.8% of the cases (p=0.56). When initial treatment consisted of stabilization with external fixation, these cases were more likely to be rehospitalized (p=0.009). Cases of open fracture also had longer hospital stays (p<0.001) and a higher readmission rate (p=0.028). Conclusion Open fractures are associated with more severe trauma, expressed in longer hospital stays and high rates of readmission. Cases of fracture which were initially treated with external fixation had a higher readmission rate. Level of Evidence II; Prospective comparative study.

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RETRACTED: A randomised prospective study of two different combined internal and external fixation techniques for distal tibia shaft fractures

Injury ◽

10.1016/j.injury.2014.10.044 ◽

2014 ◽

Vol 45 (12) ◽

pp. 1990-1995 ◽

Cited By ~ 4

Author(s):

Liao-Jun Sun ◽

Xian-Bin Yu ◽

Cheng-Qian Dai ◽

Wei Hu ◽

Xiao-Shan Guo ◽

...

Keyword(s):

Prospective Study ◽

External Fixation ◽

Distal Tibia ◽

Shaft Fractures ◽

Tibia Shaft Fractures ◽

Fixation Techniques ◽

Tibia Shaft

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External fixation in the treatment of open tibial shaft fractures

Vojnosanitetski pregled ◽

10.2298/vsp0805343g ◽

2008 ◽

Vol 65 (5) ◽

pp. 343-348 ◽

Cited By ~ 4

Author(s):

Zoran Golubovic ◽

Predrag Stojiljkovic ◽

Lana Macukanovic-Golubovic ◽

Dragan Milic ◽

Sasa Milenkovic ◽

...

Keyword(s):

External Fixation ◽

Tibial Fracture ◽

Tibial Fractures ◽

Open Tibial Fractures ◽

Shaft Fractures ◽

Tibia Shaft Fractures ◽

The Mean ◽

Pin Track ◽

Tibia Shaft ◽

Tibial Shaft Fractures

Background/Aim. Besides the conquasant fractures, open tibia shaft fractures belong to the group of the most severe fractures of tibia. Open tibia shaft fracture is one of the most common open fractures of long bones. They most frequently occur as a result of traffic accidents caused by the influence of a strong direct force. Methods. Within the period from January, 2000 to December 31, 2005. at the Clinic for Orthopaedics and Traumatology, Clinical Center Nis, 107 patients with open tibial fractures were treated. We analyzed 96 patients with open tibial fracture. In the series analyzed, the male sex was prevalent - there were 74 men (77.08%). The mean age was 47.3 years. The youngest patient was 17 years old, while the oldest patient was 79. According to the classification of the Gustilo et al. in the analysed group there were 30 (31.25%) open tibial fractures of the I degree, 31 (32.29%) of the II degree, 25 (26.05%) of the III A degree, 8 (8.33%) of the III B degree and 2 (2.08%) of the III C degree. In 95 of the patients the treatment of open tibia shaft fractures consisted of the surgical treatment of wound and the external fixation of the fractured bone using "Mitkovic" type external fixator with a convergent method of pin applications. One primary amputations had been done in patients with grade IIIC open tibial fracture with large soft tissue defect. Results. Of the 96 open tibial fractures available for follow-up, 73 (76.04%) healed without severe complications (osteitis, pseudoarthrosis, valgus malunion and amputation). Ther were nine (9.38%) soft tissue pin track infections and six (6.25%) superficial wound infections. The mean time of union was 21 (14-36) week. Among severe local complications associated with open tibial fractures, in eight patients (8.33%) was registered osteitis, and in nine patients (9.38%) fracture nonunion and the development of pseudoarthrosis. Three of the patients (3.13%) had more than 10 degree valgus malunion. In one patients (1.04%) deep pin track infection developed. Two patients (2.08%) had below the knee amputation (one primary in patient with type III C open fracture and one secondary after the development of deep infections). Conclusion. Surgical treatment of wounds, external fixation, leaving the wounds open and performing necessary debridements, adequate drug therapy administration are essential for obtaining good results in patients with open tibial shaft fractures.

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Tibia Shaft Fractures Treated with the Hoffmann External Fixation

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.1985.20.3.477 ◽

1985 ◽

Vol 20 (3) ◽

pp. 477

Author(s):

Myung Chul Yoo ◽

Dae Kyung Bae ◽

Il Hyung Cho ◽

Bang Sub Lee

Keyword(s):

External Fixation ◽

Shaft Fractures ◽

Tibia Shaft Fractures ◽

Tibia Shaft

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Segmental Tibia Shaft Fractures – Extra Articular Ilizarov Reduction Techniques

Fracture Reduction and Fixation Techniques ◽

10.1007/978-3-030-24608-2_27 ◽

2020 ◽

pp. 351-371

Author(s):

Paul Harwood ◽

David Martin Taylor

Keyword(s):

Reduction Techniques ◽

Shaft Fractures ◽

Tibia Shaft Fractures ◽

Tibia Shaft

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

10.21203/rs.3.rs-155611/v1 ◽

2021 ◽

Author(s):

Yanshi Liu ◽

Jialin Liu ◽

Maimaiaili Yushan ◽

Zhenhui Liu ◽

Tao Zhang ◽

...

Keyword(s):

Clinical Outcomes ◽

Taylor Spatial Frame ◽

Bone Union ◽

Fracture Reduction ◽

Tibial Shaft ◽

Clinical Visit ◽

Spatial Frame ◽

Shaft Fractures ◽

Definitive Management ◽

Tibial Shaft Fractures

Abstract 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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External skeletal fixation of the tibial shaft fractures

Vojnosanitetski pregled ◽

10.2298/vsp0501011m ◽

2005 ◽

Vol 62 (1) ◽

pp. 11-15 ◽

Cited By ~ 2

Author(s):

Sasa Milenkovic ◽

Milorad Mitkovic ◽

Mile Radenkovic

Keyword(s):

External Fixation ◽

External Fixator ◽

Weight Bearing ◽

Early Mobilization ◽

Tibial Shaft ◽

Closed Fracture ◽

Early Weight Bearing ◽

Shaft Fractures ◽

Pin Tract Infection ◽

Tibial Shaft Fractures

Aim. To present the possibility of a successful use of external skeletal fixation in treating the open and closed tibial shaft fractures with Mitkovic?s external fixator. Methods. External fixation was used in 115 patients with 118 fresh tibial shaft fractures, 82 males (71.3%) and 33 females (28.7%), average age 43.92 years (16?84). Open tibial shaft fractures were present in 37 (31.36%). All the fractures were treated with Mitkovic?s external fixator type M 20. Results. The results of external fixation were excellent or good in 94.07% of the cases, and bad in 5.08%. Pin tract infection appeared in 7 (5.93%) patients. In only 3 cases an external fixator was removed and treatment continued with the functional braces. Nonunion occurred in 6 (5.08%) patients, of which 4 were with open fractures (2 Gustilo type IIIB, 1 Gustilo type IIIA, 1 Gustilo type II) and 2 with the segment fractures. Compartment syndrome was observed in 1 (0.85%) patient with closed fracture. Malunion was found in 2 (1.69%) patients. Conclusion. External fixation of tibial shaft fractures is a simple and effective method to enable the safe healing of fractures, early mobilization of the patients, early weight-bearing, as well as early rehabilitation. Fixation of tibial shaft fractures was unilateral with convergent pins orientation, and there was also a possibility of compression and distraction.

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