The Use of the Taylor Spatial Frame in Treating Tibial Osteomyelitis Following Traumatic Tibial Fracture.

IF 1 Q3 ORTHOPEDICS Strategies in Trauma and Limb Reconstruction Pub Date : 2024-01-01 DOI:10.5005/jp-journals-10080-1613

Rahul Geetala, James Zhang, Daniel Maghsoudi, Amindu Madigasekara, Matija Krkovic

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Abstract

Introduction: Tibial osteomyelitis can follow open fractures with bacteria colonising the wound and persisting through biofilm and sequestrum formation. The treatment is complex, requiring eradication through debridement before limb reconstruction, for which the Taylor spatial frame (TSF) is one option. This study evaluates patient outcomes after reconstruction and identifies factors associated with post-operative complications.

Materials and methods: Fifty-one cases of tibial osteomyelitis were treated by the Ilizarov technique from 2015 to 2021 at a major trauma centre. Bacterial samples and treatment factors were assessed. Patient outcomes were complication rates and time to bony union. Complications were expressed as odds-ratios (OR) with 95% confidence intervals. Linear regression was used to assess factors associated with time to union.

Results: The mean follow-up was 24.1 months with the mean time to radiological union being 11 months. Post-operative complications were noted in 76.5% of patients with pin-site infections most common (52.9%), followed by fracture malunion (29.4%). Smoking was associated with increased fracture malunion (OR = 4.148, 95% confidence Interval [1.13-15.18], p = 0.031). The time to union was positively associated with complications, age and time to full weight-bearing (FWB). All other measured factors were found not significant.

Conclusion: Tibial osteomyelitis is treated reliably by debridement and reconstruction using the Ilizarov technique using a TSF application. The most common complication was pin-site infection. Optimising patients through cessation of smoking and encouraging post-operative weight-bearing can reduce the complication rate and improve time to union.

Clinical significance: The Ilizarov technique using a TSF can treat significant deformities that result from the management of tibial osteomyelitis.

How to cite this article: Geetala R, Zhang J, Maghsoudi D, et al. The Use of the Taylor Spatial Frame in Treating Tibial Osteomyelitis Following Traumatic Tibial Fracture. Strategies Trauma Limb Reconstr 2024;19(1):32-35.

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使用泰勒空间框架治疗外伤性胫骨骨折后的胫骨骨髓炎。

引言胫骨骨髓炎可能发生在开放性骨折之后，细菌会在伤口处定植，并通过生物膜和固着层的形成持续存在。治疗很复杂，需要在肢体重建前通过清创来根除细菌，泰勒空间框架（TSF）就是一种选择。本研究评估了患者重建后的效果，并确定了与术后并发症相关的因素：从 2015 年到 2021 年，一家大型创伤中心采用 Ilizarov 技术治疗了 51 例胫骨骨髓炎患者。对细菌样本和治疗因素进行了评估。患者预后为并发症发生率和骨结合时间。并发症以几率比（OR）表示，置信区间为95%。线性回归用于评估与骨结合时间相关的因素：平均随访时间为 24.1 个月，平均骨结合时间为 11 个月。76.5%的患者出现了术后并发症，其中以针眼感染最为常见（52.9%），其次是骨折愈合不良（29.4%）。吸烟与骨折愈合不良率增加有关（OR = 4.148，95% 置信区间 [1.13-15.18]，p = 0.031）。骨折愈合时间与并发症、年龄和完全负重（FWB）时间呈正相关。结论：结论：胫骨骨髓炎可通过使用TSF应用伊利扎罗夫技术进行清创和重建，治疗效果可靠。最常见的并发症是针尖部位感染。通过戒烟和鼓励术后负重来优化患者，可降低并发症发生率，延长骨结合时间：临床意义：使用TSF的Ilizarov技术可以治疗因胫骨骨髓炎导致的严重畸形：Geetala R, Zhang J, Maghsoudi D, et al.使用泰勒空间框架治疗创伤性胫骨骨折后的胫骨骨髓炎。Strategies Trauma Limb Reconstr 2024;19(1):32-35.

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来源期刊

Strategies in Trauma and Limb Reconstruction Medicine-Orthopedics and Sports Medicine

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1.50

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期刊介绍： Strategies in Trauma and Limb Reconstruction is dedicated to surgeons, allied medical professionals and researchers in the field of orthopaedics and trauma. The scope of the journal is to discuss the fields of skeletal injury, and the complications thereof, congenital and acquired limb deformities and deficiencies, and orthopaedic-related infection, together with their surgical and non-surgical treatments. The journal publishes original articles, reviews, case reports, descriptions of new or recognised treatment techniques, forum discussions of clinical scenarios and relevant correspondence. It aims to provide a widely accessible source of useful information to practitioners in the field through the problem- or technique-based approach of published articles.