scholarly journals Application of Intelligent Computer Information Assisted Taylor Three-dimensional External Fixation in the Treatment of Tibiofibular Fracture (Preprint)

2020 ◽  
Author(s):  
Hongfeng Sheng ◽  
Weixing Xu ◽  
Bin Xu ◽  
Hongpu Song ◽  
Di Lu ◽  
...  
Keyword(s):  
Internal Fixation ◽  
External Fixation ◽  
External Fixator ◽  
Tissue Injury ◽  
Plate Fixation ◽  
Soft Tissue Injury ◽  
Three Dimensional ◽  
High Energy ◽  
Tibial Fractures ◽  
Intelligent Computer

BACKGROUND Background: With the development of social economy, severe and complex tibial fractures caused by high-energy injuries such as traffic accidents have gradually increased. At present, the commonly used methods for the treatment of tibial fractures include plate fixation, intramedullary nail fixation, and external fixation. Most of these fractures are open wounds with severe soft tissue injury and wound contamination, and some even have bone defects, which makes the previous internal fixation treatment difficult. OBJECTIVE Objective: This study was aimed to explore Intelligent Computer Information Assisted Taylor Three-dimensional External Fixation for the treatment of tibiofibular fractures. METHODS Methods: 70 patients were collected and divided into Taylor three-dimensional external fixation (TSF) group (28 patients with severe tibial fractures treated with TSF) and the internal fixation group (42 patients with severe complicated tibiofibular fractures treated by internal fixation). After the treatment, the follow-up evaluation of Intelligent Computer Information Assisted Taylor's three-dimensional external fixator for the treatment of tibiofibular fractures and concurrency the incidence of the disease, as well as the efficacy and occurrence of the internal fixation of the treatment of tibial fractures in our hospital. RESULTS Results: The results showed that Intelligent Computer Information Assisted Taylor's three-dimensional external fixator was superior to orthopaedics in the treatment of tibiofibular fractures in terms of efficacy and complications. CONCLUSIONS Conclusions: Intelligent Computer Information Assisted Taylor three-dimensional external fixation in the treatment of tibiofibular fractures is more effective, and the incidence of occurrence is low, is a new technology for the treatment of tibiofibular fractures which is worthy of clinical promotion. CLINICALTRIAL

Clinical Value of Computer-Assisted Taylor Three-dimensional External Fixation in the Treatment of Tibiofibular Fracture (Preprint)

2020 ◽  
Author(s):  
Hongfeng Sheng ◽  
Weixing Xu ◽  
Bin Xu ◽  
Hongpu Song ◽  
Di Lu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Internal Fixation ◽  
External Fixation ◽  
External Fixator ◽  
Theoretical Basis ◽  
New Technology ◽  
Three Dimensional ◽  
Computer Assisted ◽  
Clinical Value

UNSTRUCTURED The retrospective study of Taylor's three-dimensional external fixator for the treatment of tibiofibular fractures provides a theoretical basis for the application of this technology. The paper collected 28 patients with tibiofibular fractures from the Department of Orthopaedics in our hospital from March 2015 to June 2018. After the treatment, the follow-up evaluation of Taylor's three-dimensional external fixator for the treatment of tibiofibular fractures and concurrency the incidence of the disease, as well as the efficacy and occurrence of the internal fixation of the treatment of tibial fractures in our hospital. The results showed that Taylor's three-dimensional external fixator was superior to orthopaedics in the treatment of tibiofibular fractures in terms of efficacy and complications. To this end, the thesis research can be concluded as follows: Taylor three-dimensional external fixation in the treatment of tibiofibular fractures is more effective, and the incidence of occurrence is low, is a new technology for the treatment of tibiofibular fractures, it is worthy of clinical promotion.

Comparison between External Locking Plate Fixation and Conventional External Fixation for Extraarticular Proximal Tibial Fractures: A Finite Element Analysis

2021 ◽  
Author(s):  
Dejan Blažević ◽  
Janoš Kodvanj ◽  
Petra Adamović ◽  
Dinko Vidović ◽  
Zlatko Trobonjača ◽  
...  
Keyword(s):  
Finite Element ◽  
External Fixation ◽  
External Fixator ◽  
Tibial Fracture ◽  
Locking Plate ◽  
Plate Fixation ◽  
Tibial Fractures ◽  
Proximal Tibial Fracture ◽  
Locking Plate Fixation ◽  
Maximum Stiffness

Abstract BackgroundGood clinical outcomes for locking plates as an external fixator to treat tibial fractures have been reported. However, external locking plate fixation is still generally rarely performed. This study aimed to compare the stability of external locking plate fixator with that of conventional external fixator for extraarticular proximal tibial fractures, using finite element analysis. MethodsThree models were constructed: (1) external locking plating of proximal tibial fracture with lateral proximal tibial locking plate and 5-mm screws (ELP), (2) conventional external fixation of proximal tibial fracture with an 11-mm rod and 5-mm Schanz screws (EF-11), and (3) conventional external fixation of proximal tibial fracture with a 7-mm rod and 5-mm Schanz screws (EF-7). The stress distribution, displacement at the fracture gap, and stiffness of the three finite element models at 30-, 40-, 50-, and 60-mm plate–rod offset from the lateral surface of the lateral condyle of the tibia were determined. ResultsThe conventional external fixator showed higher stiffness than did the external locking plate fixator. In all models, the stiffness decreased as the distance of the plate–rod from the bone surface increased. The maximum stiffness was 121.06 N/mm in the EF-11 model with 30-mm tibia–rod offset. In the EF-7 model group, the maximum stiffness was 40.00 N/mm in the model with 30-mm tibia–rod offset. In the ELP model group, the maximum stiffness was 35.79 N/mm in the model with 30-mm tibia–plate offsetConclusionsExternal locking plate fixation is more flexible than conventional external fixation, which can influence secondary bone healing. External locking plate fixation requires the placement of the plate as close as possible to the skin, which allow low-profile design, because the increased distance of the plate from bone can be too flexible for bone healing.

Ankle spanning external fixator with limited internal fixation for distal tibial extra-articular fractures

2017 ◽  
Vol 5 (10) ◽  
pp. 4355
Author(s):  
Siddharth Goel ◽  
Abhay Elhence
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
External Fixation ◽  
External Fixator ◽  
Tibial Fractures ◽  
Fixation Method ◽  
Ankle Pain ◽  
Distal Tibial Fractures ◽  
Tract Infections

Background: Fractures of the distal tibia are among the most difficult fractures to treat. The short distal segment presents difficulty in choosing the appropriate fixation method. The greatest challenge lies in the relatively tight soft tissue around the ankle. As a result, it has been a recent interest in treating these fractures with external fixation and limited internal fixation. The external stable fixation methods used are tubular or ring fixators, with or without immobilising the ankle. This minimally invasive nature of the surgery can avoid catastrophic wound complications like dehiscence, implant exposure and infection.Methods: 18 patients with extra-articular distal tibial fractures (AO Type 43A) were treated with the technique of ankle spanning external fixation. Lag screws or K-wires were supplemented for limited internal fixation when required. Fibula was stabilised in all cases. Intra- articular and Compound fractures were excluded. In addition to union at fracture site, ankle pain and motion was noted in each follow-up.Results: The mean follow-up was 25 months. Of the 18 patients included all but one fractures united with an average healing time of 16 to 18 weeks. Ankle pain and motion was graded according to Mazur modified by Teeny and Wiss clinical scoring system. 15 of them had excellent or good results, 2 had fair results. One patient had poor result. Five pin tract infections occurred. 17 patients had no evidence of osteoarthritis after completing follow up of at least 2 years.Conclusions: Distal tibial fractures are complex injuries, not only regarding the bony component, but also in terms of the management of the soft tissue problem. Ankle Spanning External Fixator with Limited Internal fixation is a relatively simple and cost-effective method for treating these fractures, achieving union and also maintaining ankle function.

scholarly journals “Fixator-assisted Nailing” Technique for Closed Segmental Tibia Shaft Fracture with Extensive Soft Tissue Injury – A Case Report

2021 ◽  
Vol 11 (8) ◽  
Author(s):  
Vivek M Sodhai ◽  
Chetan V Pradhan ◽  
Parag K Sancheti ◽  
Ashok K Shyam
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Internal Fixation ◽  
External Fixator ◽  
Road Traffic ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Treatment Strategies ◽  
Soft Tissue Injuries ◽  
Definitive Treatment

Introduction: Segmental tibia fractures with extensive soft tissue injuries are rare and surgical intervention is challenging with no definitive treatment strategies. Case Report: A 52-year-old man presented with closed right segmental tibia and fibula fracture with extensive blistering of skin caused due to road traffic accident. Distal pulses were palpable and there were no signs of compartment syndrome and other systemic injuries. In the presence of extensive blistering, a monoplanar external fixator was applied within 24 h of injury. 3 weeks later, skin condition was conducive for internal fixation, and closed intramedullary multi-locking nailing was performed using the external fixator for reduction. Fracture healed at 15 months and patient had an excellent functional outcome with full knee range of motion at 2-years follow-up without any complications. Conclusion: Fixator-assisted nailing is a simple, minimally invasive, and easily reproducible technique that is useful in reducing the fracture and preventing axial rotation of the intercalary segment minimizing the damage to the periosteal blood supply. Our case also highlights the importance of temporary external fixator in soft tissue healing and making the skin conducive for internal fixation. Keywords: Devascularization, fixator-assisted nailing, intercalary segment, rotational displacement, segmental tibial fracture.

scholarly journals A Prospective Observational Study on Efficacy of Ilizarov External Fixation in Infected Non-Union Tibial Fractures

2021 ◽  
Vol 8 (15) ◽  
pp. 932-938
Author(s):  
Avinash Gundavarapu ◽  
Vishal Singh ◽  
Prashant Kumar Mishra ◽  
Santhosh Kumar M
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Functional Results ◽  
High Energy ◽  
Tibial Fractures ◽  
Bony Union ◽  
Ilizarov External Fixator ◽  
Non Union ◽  
Ring Fixator ◽  
Study Results

BACKGROUND Open fractures and fractures caused by high-energy trauma are likely to get infected and result in non-union. Infected non-union of long bones is a problem in developing countries like India. Ilizarov external fixator was employed to correct all the complications associated with non-union such as bone gap, infection, shortening, and deformities. Stable fixation, corticotomy and bone transport was employed to reduce or eliminate infection at the same time achieving bone union and correction of limb length discrepancy. Our study assesses the efficacy and safety of Ilizarov external fixation in patients with infected non-union tibial fractures. METHODS A series of 30 patients with infected non-union of tibia were treated with Ilizarov external fixation in Yashoda super speciality hospital and regularly followed-up between May 2014 and April 2016 (2 years). Bony and functional results were estimated and correlated with existing studies. RESULTS Out of thirty patients treated, bony results were excellent in 17 patients, good in 8 patients, fair in 4 patients and poor in 1 patient. Functional results were excellent in 17 patients, good in 5 patients, fair in 5 patients, and poor in 3 patients. Average duration of the fixator period was 8.1 months (min - 3 months, max - 14 months). Average length of regenerate was 3.64 cm (min - 2 cm, max - 6 cm). Average lengthening index in the study was 2.09 months / cm. Our study in all 4 categories of Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria had approached Dror Paley’s Bony results and functional results. CONCLUSIONS In our study results have been encouraging in addressing all the complex problems by Ilizarov principle. Ilizarov external fixator system is the best device to treat infected non-union of tibia. Distal third of tibia is more prone for infection and non-union. Corticotomy or bone grafting is required for augmentation of the healing process. Almost all patients had varying degrees of oedema and pin track infections. Infection was controlled in all the cases and bony union was achieved, no patient had persistence of non-union and infection at the end of 2 years. KEYWORDS Ilizarov External Ring Fixator, Infected Non-Union, ASAMI Criteria, Bony Results, Functional Results, Bony Union

scholarly journals Treatment of Open Proximal Humerus Fracture by Gunshot

2012 ◽  
Vol 15 (1) ◽  
pp. 37-42
Author(s):  
Sung Jae Kim ◽  
Jae Hoo Lee ◽  
Yong Min Chun
Keyword(s):  
Internal Fixation ◽  
External Fixator ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Fracture Site ◽  
Humerus Fracture ◽  
Wound Debridement ◽  
Fracture Management

PURPOSE: To consider the proper managment of proximal humerus fracture on gunshot wounds.MATERIALS AND METHODS: A 28-year-old male patient, who sustained a gunshot injury on the left arm 5 days ago, was admitted through the emergency department. Although he underwent an emergency surgery (bullet fragment removal and debridement), there remained bullet fragments around the proximal humerus fracture site. The wound seemed to be infected and a partial dehiscence occurred. No neurologic deficit was noted. Immediate exploration and debridement were performed, and an external fixator was applied to restore the anatomical alignment and manage the wounds. Intravenous antibiotics were administered. On the 9th postoperative day, wound debridement was done again, and cement beads mixed with antibiotics were inserted. After two weeks, the external fixator was removed, and the pin sites were closed after debridement. One week later, the open reduction and internal fixation with locking compression plate and screws were done.RESULTS: At 3 months after the internal fixation, the bone union was obtained with satisfactory alignment of the humerus.CONCLUSION: The severity of the soft tissue injury influences the fracture management plan. Further, the risk on lead toxicity should be considered.

scholarly journals Early complications of preoperative external traction fixation in staged treatment of tibial fractures: a 402 cases series study

2020 ◽  
Author(s):  
Jiazhao Yang ◽  
Wanbo Zhu ◽  
Qirong Dong
Keyword(s):  
Soft Tissue ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
High Energy ◽  
Study Data ◽  
Fracture Site ◽  
Tibial Fractures ◽  
Early Complications ◽  
The Mean ◽  
Staged Treatment

Abstract Background and Objective: Different external skeletal fixators have been widely used in preoperative traction of high-energy tibial fractures prior to a definitive surgical treatment. However, early complications associated with this staged treatment for traction and soft tissue injury recovery have rarely been discussed. This study aimed to analyze the early complications associated with preoperative external traction fixation in the staged treatment of tibial fractures.Materials and Methods: A total of 402 patients with high-energy tibial fractures treated using preoperative external traction fixation at a level-1 trauma center from 2014 to 2018 were enrolled in this retrospective study. Data regarding the demographic information, Tscherne soft tissue injury, fracture site, entry point placement, and duration of traction were recorded. Procedure-related complications such as movement and sensation disorder, vessel injury, discharge, infection, loosening, and iatrogenic fracture were analyzed.Results: The mean patient age was 42.5 (18–71) years and the mean duration of traction was 7.5 (0–26) days. In total, 19 (4.7%) patients presented with procedure-related complications, including technique-associated complications in 6 patients and nursing-associated complications in 13. Differences in the incidence of complications with respect to sex, affected side, soft tissue injury classification, and fracture sites were not observed. However, the number of complications due to hammer insertions was significantly fewer than those due to drill insertions (2.9% vs. 7.4%).Conclusion: The application of preoperative external traction fixation had been proved to be an ideal alternative treatment for high energy tibial fractures. In this study, we found the incidence of early complications of the fixation is low, and it is not significantly associated with the severity of soft tissue injury and fracture site. Although relatively rough and more likely to cause pain, complications of hammer insertions were significantly fewer than drill insertions. The possible reason was higher probability of heat damage and loosening by drilling.

Tibial plateau fractures

2011 ◽  
Author(s):  
Phil Walmsley ◽  
John Keating
Keyword(s):  
Internal Fixation ◽  
External Fixation ◽  
Tibial Plateau ◽  
Soft Tissues ◽  
Plate Fixation ◽  
High Energy ◽  
Soft Tissue Envelope ◽  
Fine Wire ◽  
Peroneal Palsy ◽  
Lateral Plateau

♦ Split depression pattern lateral plateau most common type♦ Bicondylar and medial plateau fractures high energy injuries♦ Compartment syndrome, vascular injury, and common peroneal palsy may occur with high energy patterns♦ Internal fixation preferred treatment with good soft tissue envelope♦ Limited internal fixation suitable for many simple patterns♦ Plate fixation preferred for medial and bicondylar fractures♦ External fixation used with poor soft tissues♦ Fine wire external fixation should be considered for most complex patterns.

scholarly journals Complex Tibial Plateau Fractures Treated with a Hybrid External Fixator – Long Term Results

2021 ◽  
Vol 48 (3) ◽  
pp. 26-29
Author(s):  
Y. Andonov
Keyword(s):  
Internal Fixation ◽  
External Fixator ◽  
Tibial Plateau ◽  
Soft Tissues ◽  
Soft Tissue Injury ◽  
High Energy ◽  
Tibial Plateau Fractures ◽  
Long Term Results ◽  
Joint Degeneration

Abstract Introduction: High energy tibial plateau fractures represent a challenge because of the combined bone and soft tissue injury. The iatrogenic impact can further increase the likelihood for crippling complications. Less invasive treatment protocols have been developed to improve the results. Objective: We present the long-term results of limited internal fixation combined with a small wire external fixator. Patients and Methods: Fourteen patients were followed for at least 10 years. Initial and final functional results, complications and presence of joint degeneration were registered according to validated rating scores. Results: Of all patients included in the study, thirteen showed an excellent initial rating and one had an average result at baseline. 10 years later, eight patients still showed excellent grading results, four – good ones, one – average and one – poor results. Ten knees (71%) had osteoarthritis. Postphlebitic syndrome was diagnosed in two cases. Three knees showed medio-lateral instability, one showed a varus and one – a valgus deformity. Knee arthroplasty was performed in one case. Conclusion: The limited internal fixation combined with a hybrid ex fix can be considered as an alternative to the ORIF, especially when the soft tissues are severely compromised. Despite the inevitable joint degeneration, the associated overall morbidity is low and the long term function is quite satisfactory.

scholarly journals External fixation combined with limited internal fixation in the treatment of pilon tibia fractures

2007 ◽  
Vol 64 (5) ◽  
pp. 307-311 ◽  
Author(s):  
Zoran Golubovic ◽  
Lana Macukanovic-Golubovic ◽  
Predrag Stojiljkovic ◽  
Jovica Jovanovic ◽  
Ivan Micic ◽  
...  
Keyword(s):  
Internal Fixation ◽  
External Fixation ◽  
External Fixator ◽  
Open Reduction ◽  
High Energy ◽  
Nonoperative Treatment ◽  
Intraarticular Fracture ◽  
Tibial Plafond ◽  
Intraarticular Fractures ◽  
Tibia Fractures

Background/Aim. Intraarticular fractures of the tibial plafond (pilon fractures) belong to the group of most severe fractures. They are usually caused by high-energy trauma and frequently associated with a marked soft-tissue damage. Surgical treatment has replaced the traditional nonoperative treatment. The aim of this study was to present the results of the treatment of distal tibial intraarticular fracture by the use of internal fixation, as well as the combination of minimal internal fixation and external fixation. Methods. The study included 47 patients with pilon tibia fractures who went through at the Clinic for Orthopedics and Traumatology, School of Medicine, Nis (1995-2004). Within the analyzed group there were 33 (70.2%) males and 14 (29.8%) females. The patients mean age was 45.8 years. In the first group, which consisted of 22 patients, open reduction and internal fixation of both the tibia and the fibula was performed in the two separate incisions. The second group consisted of 25 patients managed with external fixation by external fixator "Mitkovic" with limited internal fixation. Besides external fixation, a minimal internal fixation was performed by the use of Kirschner wires and screws. The patients were followed-up inside a 24-months-period. Results. The obtained was a substantially high number of complications after open reduction and internal fixation in the group of patients. There was no difference in a long-term clinical outcome. Postoperative osteitis, as the most severe complication in the management of closed pilon tibia fractures, was not registered in the second group. Conclusion. Considering the results obtained in this study, it can be concluded that external fixation by the "Mitkovic" external fixator with the minimal internal fixation is a satisfactory method for the treatment of fractures of the tibial plafond causing less complications than internal fixation. .

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