The Assessment Of The Application Of Taylor Spatial Frame In The Treatment Of Intermediate Or Distal Tibiofibular Fractures

Background The purpose of this study was to determine the clinical effectiveness and the safety of the Taylor spatial frame in treat intermediate or distal tibiofibula fractures.Methods The clinical data of 98 patients with intermediate or distal tibiofibular fractures treated from Oct 2016 to March 2018 were retrospectively analyzed.According to different methods of fixation,they were divided into internal fixation group(36 cases)and external fixation group(62 cases).There were no significant differences in the age,sex,cause of injury,type of fracture,time from injury to operation between the two groups(p>0.05).The intraoperative blood loss,fracture healing time,fixation time and complications were recorded and compared.The final function evaluation criteria of Johner-Wruhs humeral shaft fracture were used to evaluate the function of the affected limb.The standard evaluation of Luo Congfeng et al.Postoperative lower limb force line recovery.Results Both groups were followed up for 6 to 22 months with a median time of 14 months.All patients had healed fractures.The intraoperative blood loss,fracture healing time and fixation time were significantly higher in the internal fixation group than in the external fixation group(p<0.05).There were 1 case of plate exposure,1 case of delayed fracture healing and 1 case of plate fracture in the internal fixation group.There were 2 cases of delayed fracture healing and 4 cases of soft tissue defect in the external fixation group.There was no significant difference in the incidence of complications between the two groups.(p>0.05).The function of the affected limb was evaluated by Johner-Wruhs standard 10 months after operation.The internal fixation group was excellent in 29 cases,good in 5 cases,and fair in 2 cases.The excellent and good rate was 94.4%.The external fixation group was excellent in 57 cases,good in 3 cases,and fair in 2 cases.The excellent and good rate was 96.7%;there was no significant difference between the two groups(p>0.05).The recovery of lower extremity line was evaluated by Luo Congfeng et al.at 4 months after operation.The internal fixation group was excellent in 32 cases,3 case was fair,1 case was poor,the excellent and good rate was 88.9%,and the external fixation group was excellent in 58 cases.3case,1 case was poor,the excellent and good rate was 96.9%;there was no significant difference between the two groups(p>0.05).Conclusion The use of Taylor spatial frame in the treatment of the middle and lower tibiofibular fractures,especially the open fractures,can give full play to the advantages of the external fixation.Percutaneous needle fixation can prevent the soft tissue and the periosteum from being cut,which is beneficial to reduce the blood supply to the soft tissue and the fracture.Destruction,promote fracture recovery;postoperative X-ray film combined with computer software to accurately reduce the fracture,correct deformity,adjust the lower limb line,delay or even avoid the occurrence of osteoarthritis caused by gravitational line changes;Taylor spatial frame is micro-dynamic frame,can effectively stimulate the formation of osteophytes at the fracture end,thereby reducing the time of fracture healing and the time of strapping.The axial measurement of the stiffness of the epiphysis in the stage can not only remove the stress shielding of the external fixation bracket,but also judge the science scientifically.The degree of healing of the epiphysis provides a new quantitative standard,which is more suitable for individualized differences in the process of fracture healing,reducing the treatment period of fractures and postoperative complications,and alleviating the pain of patients.It is a fixed and reliable treatment with satisfactory therapeutic effect.A technique for the treatment of the lower and middle tibia,especially open fractures,with less complications.