Fracture healing following high energy tibial trauma: Ilizarov versus Taylor Spatial Frame

Abstract

Despite the assumption of the rigid construct of the TSF, the median time to union was similar to that of the Ilizarov frame and the TSF therefore can play a significant role in complex tibial fractures.

The “Road to Union” protocol for the reconstruction of isolated complex high-energy tibial trauma

“…Minor pin tract infections occurred in 11 cases (34%), all of which successfully resolved with oral antibiotics and local wound care. These rates are similar to previously reported findings on pin tract complications in several studies [3,24,34,35]. In addition, three patients had persistent non-union, one patient fractured through his regenerate, and one patient sustained a stress fracture at the docking site.…”

“…One patient required multiple adjustments of his fixator resulting in a shortened tibia requiring subsequent limb lengthening. The overall complication rate was 53%, but when subtracting the cases with pin tract infections the major complication rate was only 19%, which is again comparable to other studies [3,33,34].…”

Current concepts in the management of open tibia fractures

“…Limited literature regarding the use of hexapod external fixation in open tibia fractures shows promising results, suggesting that the hexapod design can play a significant role in managing complex tibia fractures. 102,103 Dickson et al recently reported on the surgical and functional outcome of 22 patients with grade III open tibia fractures treated with circular external fixation at a minimum one-year follow-up. 4 Clinical scores were either good or excellent in over half of the patients in all knee and ankle scores, with good functional outcome in most cases.…”

What’s New in Limb Lengthening and Deformity Correction

“…In another prospective randomized study involving sixty-eight adults with open tibial shaft fractures, treatment with biplanar external fixation compared with reamed locked intramedullary nailing had similar healing rates and functional outcomes one year postoperatively 57 . Based on a review of 112 high-energy tibial fractures treated with either Ilizarov or Taylor Spatial Frame fixation, the time to union was similar in both groups (median, 163 days) 58 . In a review of complex fractures (eleven femoral fractures and fifty-seven tibial fractures) that were not amenable to standard open reduction techniques, treatment with ring fixation resulted in a 93% union rate 59 .…”