To Observe The Efficacy Of Taylor Space Stent In The Treatment Of Complex Fractures Of The Middle And Distal Tibia

Objectives To investigate the clinical feasibility of Taylor spatial stent in the treatment of complex fractures of the middle and lower tibia,and to scientifically evaluate the clinical efficacy of Taylor spatial stent in the treatment of fractures.Methods A total of 30 patients who were hospitalized in a hospital from October 2020 to March 2023 and met the inclusion and exclusion criteria were selected.The patients aged between 18 and 55 years old,including 20 male patients and 10 female patients.According to the fixation method,they could be divided into combined external fixator group(15 cases)and Taylor space external fixator group(15 cases).All participants underwent surgery by the same clinician,and were guided by professional rehabilitation therapists after surgery.After discharge,they were regularly communicated with the patients by telephone.According to the X-ray and CT scan results,through a comprehensive examination and evaluation,the deformation,deformity and healing state of the fracture site were determined,and individualized rehabilitation programs were formulated based on these information.The fracture healing time,fixation removal time,and complications were recorded and compared between the two groups.For the limb that was removed after fracture healing,the tibial shaft fracture of the two groups was evaluated according to Johner-Wruhs scoring scale to evaluate the ability of the affected limb.Results All patients were followed up for 6-12 months,with a median time of9 months.Postoperative follow-up data showed that the fracture healing time and the time of fixation removal from the fracture in the combined external fixator group were longer than those in the Taylor space stent group,and the differences were statistically significant(p<0.05).The postoperative complications in the combined external fixation group were: 1 case of malunion,1 case of pin breakage,1 case of pin site infection,and1 case of soft tissue necrosis.The complications of Taylor space stent group were: 1case of pin site infection;There was no significant difference in the incidence of complications between the two groups(p>0.05).After operation,Johner-Wruhs scale was used to compare the treatment effect of tibial shaft fracture between the two groups,and to evaluate the function of the affected limb.In the combined external fixation group,6 cases were excellent,3 cases were good,22 cases were fair,and 4 cases were poor,with an excellent and good rate of 60.00%.In the Taylor spatial stent group,9cases were excellent,5 cases were good,and 1 case was fair,with an excellent and good rate of 93.33%.There was significant difference in the excellent and good rate between the two groups(p< 0.05).Conclusion We used Taylor external fixator in the treatment of complex fractures of the middle and lower tibia and open fractures,closed pin fixation of the fracture end,which can effectively protect the soft tissue and peripheral blood circulation,so as to maintain the physiological environment of the fracture site and accelerate the fracture healing.In the postoperative treatment stage,clinicians can accurately reduce the fracture,correct the deformity of the fracture end,and readjust the overall alignment of the lower leg to avoid fracture malunion or later osteoarthritis with the help of X-ray and other imaging examinations and supporting computer software.In the rehabilitation stage,the clinicians observed the formation of callus at the fracture end by X-ray film,combined with the axial measurement of callus stiffness and other methods to determine the degree of fracture healing and the time of removal of external fixator.