Comparison of three fixation methods in treatment of tibial fracture in adolescents

Li, Lin; Liu, Yang; Lin, Chuanlu; Zhou, Yifei; Feng, Yongzeng; Shui, Xiaolong; Yu, Ke; Lu, Xiaoyong; Jiang, Hong; Yu, Yan

doi:10.1111/ans.14258

Cited by 13 publications

(9 citation statements)

References 12 publications

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“…Five studies [17,23,24,28,30] reported the length of hospital stay for both study cohorts. All the studies found the patients in the circular external fixation cohort had shorter hospital stays than those in the ORIF cohort (Fig 4).…”

Section: Plos Onementioning

confidence: 99%

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Comparison between open reduction with internal fixation to circular external fixation for tibial plateau fractures: A systematic review and meta-analysis

Wang

et al. 2020

PLoS ONE

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Peer-reviewed published studies on tibial plateau fractures treated with either open reduction with internal fixation (ORIF) or circular external fixation were reviewed to compare functional, radiological outcomes, postoperative complications, and reoperation rates between the two methods. A systematic search of various databases including Medline, Cochrane Controlled Register of Trials (CENTRAL), ScienceDirect, and Google Scholar from inception until June 2019 was performed. 17 studies with 1168 participants were included in the review. Most of the studies (76%) were retrospective in nature and had low or unclear bias risks. Incidence of total infection (Odds ratio [OR], 2.58; 95% CI, 1.33-5.02) and malunions (OR, 2.56; 95% CI, 1.12-5.84) were higher and length of hospital stay was shorter in patients treated with circular external fixator (Mean difference [MD],-6.1; 95% CI,-11.1-1.19). There were no differences in the incidence of secondary osteoarthritis (OR, 1.49; 95% CI, 0.92-2.42), range of motion (MD, 2.28; 95% CI,-11.27-15.82) non-union (OR, 1.44; 95% CI, 0.14-14.27) and reoperation rates (OR, 1.84; 95% CI, 0.90-3.78) between the two groups. Results from this investigation suggest that circular fixation may offer some advantages over ORIF such as a shortened length of hospital stay and early return to preinjury activities. Definitive clinical recommendations cannot be made as it also presents higher rates of postoperative complications than ORIF.

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Section: Plos Onementioning

confidence: 99%

“…Five studies [17,18,26,29,30] reported data on malunions. Our meta-analysis indicates circular external fixator compared to ORIF results in a significantly higher chance of developing malunion (OR, 2.56; 95%CI, 1.12-5.84; I 2 = 49%; p = 0.03) ( Fig 6A).…”

Section: Plos Onementioning

confidence: 99%

Comparison between open reduction with internal fixation to circular external fixation for tibial plateau fractures: A systematic review and meta-analysis

Wang

et al. 2020

PLoS ONE

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“…Their findings indicated that circular external fixator compared to ORIF resulted in a significantly higher chance of developing malunion (OR, 2.56; 95% CI, 1.12-5.84; I2 = 49%; p = 0.03). Whether this is attributable to the treatment itself, the thin-wire circular device, or the severity of the injury was unclear, a prolonged healing time for tibial fractures treated with external fixators has been reported in the literature, which may lead to an increased risk of loss of wire pre-tension, potentially affecting the process of fracture healing [22,23]. It has been shown that changes in the mechanical properties of a fracture site affect the time taken for a fracture to heal, thus modifying the type and proportion of tissues formed [24].…”

Section: Discussionmentioning

confidence: 99%

Limb Salvage after Lower-Leg Fracture and Popliteal Artery Transection—The Role of Vessel-First Strategy and Bone Fixation Using the Ilizarov External Fixator Device: A Case Report

et al. 2021

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Open traumatic lesion of the popliteal artery is relatively rare. Ischemia time longer than 6 h and severity of limb ischemia have been shown to be associated with an increased risk of limb loss. Severe local infection is critical in the presence of major soft tissue trauma or open fractures. We report the case of a young female who suffered a traumatic transection of the popliteal artery associated with an open fracture of the distal tibia and fibula managed by direct vessel reconstruction with an end-to-end repair and skeletal stabilization initially with half-pin external fixation, then replaced by an Ilizarov circular frame. The patient had a very satisfactory outcome, but the fracture healed malunited, later corrected by open reduction and internal fixation with lag-screwing and a neutralization plate.

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“…The incidence of tibial intercondylar crest fracture in adults is increasing with the increase in sports injuries and traffic accidents. These fractures can recover well in both children and adults if treated effectively at an early stage of tibial eminence avulsion injury [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

The most economical arthroscopic suture fixation for tibial intercondylar eminence avulsion fracture without any implant

Yuan¹,

Shi²,

Chen

et al. 2022

J Orthop Surg Res

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Background Avulsion fracture of the tibial intercondylar eminence is a rare injury, which mainly occurs in adolescents aged 8–14 years and in those with immature bones. The current commonly used surgery may result in severe surgical trauma, affecting knee joint function and accompanied by serious complications. In this study, we described an all-inside and all-epiphyseal arthroscopic suture fixation technique for a patient to treat tibial intercondylar eminence fracture. Methods ETHIBOND EXCEL-coated braided polyester sutures were used for fixation. Three ETHIBOND sutures were passed through the ACL at 2, 6 and 10 o’clock of the footprint of the ACL and made a cinch-knot loop separately. Under the guidance of ACL tibial locator, three corresponding tibial tunnels were drilled with K-wires at 2, 6 and 10 o’clock of the fracture bed, and the two ends of the suture were pulled out through the tunnel with double-folded steel wire heads. After reduction of the tibial eminence, three sutures were tightened and tied to the medial aspect of the tibial tubercle. Results After all the surgical treatments surgically performed by this method and following a standard postoperative protocol, our patient's ROM, stability, and functional structural scores all improved significantly. Conclusion This three-point suture technique provides a suitable reduction and stable fixation and is suitable for patients with all types of avulsion fractures of the tibial intercondylar eminence.

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Comparison of three fixation methods in treatment of tibial fracture in adolescents

Cited by 13 publications

References 12 publications

Comparison between open reduction with internal fixation to circular external fixation for tibial plateau fractures: A systematic review and meta-analysis

Comparison between open reduction with internal fixation to circular external fixation for tibial plateau fractures: A systematic review and meta-analysis

Limb Salvage after Lower-Leg Fracture and Popliteal Artery Transection—The Role of Vessel-First Strategy and Bone Fixation Using the Ilizarov External Fixator Device: A Case Report

The most economical arthroscopic suture fixation for tibial intercondylar eminence avulsion fracture without any implant

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