Vasileios P Giannoudis, Emma Ewins, D Martin Taylor, Patrick Foster, Paul Harwood
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引用次数: 4
Abstract
Aims and objectives: To examine clinical and functional outcomes in patients with intra- and extra-articular distal tibial fractures treated definitively by Ilizarov fixation.
Materials and methods: Patients with tibial fractures extending within 1 Müller square of the ankle joint were identified from our Ilizarov database over a 5-year period. Data on treatment and outcome were assembled from this database and supplemented by a review of patient records. General measures of health-related quality of life and limb-specific functional outcome scores were recorded. Adverse events were documented according to Paley's classification.
Results: One hundred and sixty-eight patients with 169 fractures were identified, 28% were open and 63% intra-articular. One hundred and sixty-five (98%) of the fractures united, two following bone grafting in their original frames, at a median of 166.5 days (range 104-537). Three patients with nonunions united with further treatment. One patient (an end-stage diabetic) elected to undergo amputation following multiple early complications during treatment. Closed fractures united more rapidly than open (median 157 vs 183 days; p = 0.005) and true Pilon (43C3) fractures took longer to unite than other fractures (median 157 vs 177 days; p = 0.01).Sixty-seven percent of patients completed functional outcome scores. Sixty-two percent reported good or excellent ankle scores at more than 6 months post frame removal, 38% fair and 10% poor. Patients with intra-articular fractures reported significantly worse ankle scores than those with extra-articular injuries. General measures of health-related quality of life (EuroQol-5D) revealed significant ongoing effects despite good clinical outcomes.
Conclusion: This study demonstrates a high union and low serious complication rate, suggesting that external ring fixation is a safe and effective treatment for these injuries.
How to cite this article: Giannoudis VP, Ewins E, Taylor DM, et al. Clinical and Functional Outcomes in Patients with Distal Tibial Fracture Treated by Circular External Fixation: A Retrospective Cohort Study. Strategies Trauma Limb Reconstr 2021;16(2):86-95.
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.
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