Management of paediatric tibial fractures using two types of circular external fixator: Taylor spatial frame and Ilizarov circular fixator

Tafazal, S; Madan, Sanjeev; Ali, Farhan; Padman, Manoj; Swift, Simone; Jones, Scott; Fernandes, James A.

doi:10.1007/s11832-014-0583-2

Cited by 25 publications

(12 citation statements)

References 20 publications

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“…It has been widely used for acute and chronic deformity treatment. 6 , 14 – 16 In comparison, the Orthex Hexapod System has only been recently introduced in the North America and has just been approved in Europe. This is the first study presenting clinical results using this novel design.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes in pediatric tibial lengthening and deformity correction: A comparison of the Taylor Spatial Frame with the Orthex Hexapod System

Messner

Chhina

Davidson

et al. 2021

Journal of Children's Orthopaedics

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Purpose Comparison of two hexapod frame systems in paediatric tibial deformity correction; the Taylor Spatial Frame (TSF) and Orthex Hexapod System. Methods Paediatric patients with congenital and acquired tibial deformities treated with either TSF (between 2014 and 2016) or Orthex (between 2017 and 2019) frames were included in a retrospective comparative study. Outcome measures were healing index, pin infection rate, regenerate quality and density, software residual rate, deformity correction accuracy, strut exchanges and quality of life (QoL). Results The TSF group had 17 patients (18 frames) and the Orthex group had 21 patients (25 frames). The most common indications for tibial deformity correction were fibular hemimelia (14) and septic or traumatic growth arrest (8). The median time in frame was 230 days (TSF) versus 203 days (Orthex) (p= 0.06). The mean lengthening achieved was 54 mm (TSF) and 51 mm (Orthex) (p = 0.41). The healing index was 41 days/cm (TSF) versus 43 days/cm (Orthex) (p = 0.70). Pin site infections occurred more in the TSF cohort (40%) than in the Orthex cohort (18%) (p < 0.001). The regenerate in the Orthex group showed higher density at three months (p = 0.029) and was more homogenous (p = 0.023) at six months after frame application. Strut exchanges were less frequent with the Orthex system (p < 0.0001). QoL measures were similar in both cohorts (p = 0.92). Conclusions This is the first study to compare two hexapod designs in paediatric orthopaedics. The Orthex system showed superiority in regenerate quality and a significant reduction in pin site infection rates. Both systems delivered predictable and accurate limb deformity correction. Level of evidence III

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Section: Discussionmentioning

confidence: 99%

Clinical outcomes in pediatric tibial lengthening and deformity correction: A comparison of the Taylor Spatial Frame with the Orthex Hexapod System

Messner

Chhina

Davidson

et al. 2021

Journal of Children's Orthopaedics

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“…The monolateral fixator is considered to have the advantage of technically easier application when compared to the ring external fixator, but concerns have been raised regarding an increased risk of loss of reduction [ 5 ]. On the other hand, the ring external fixator has a stable structure and stronger fixing force than the monolateral external fixator, resulting in a lower risk of loss of reduction and the advantage that full weight-bearing can be applied from immediately postoperatively [ 5 , 6 ]. In addition, the ring external fixator offers the advantage of minimizing damage to soft tissues, as the device is fixed with wires.…”

Section: Discussionmentioning

confidence: 99%

“…Each treatment method offers specific advantages. The ring external fixator has the advantage of allowing full weight-bearing from immediately after surgery, with no need for rest limitations because the fixator is a biomechanically stable construct [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Open tibial shaft fracture in a boy with autism spectrum disorder treated using a ring external fixator: A case report

Mita

Nozaka

Miyakoshi

et al. 2021

Trauma Case Reports

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Autism spectrum disorder covers a group of behaviorally defined disorders that may result in the patient having difficulty staying calm during medical treatments, due to anxiety-related overreactions. Tibial fractures are the third most common pediatric long-bone fracture. Conservative treatment is selected in many cases, but surgical treatment may be selected in cases of open fracture and no treatment policy has been established. We described the case of a 6-year-old boy with autism spectrum disorder who was unable to stay calm due to anxiety and required sedation. We diagnosed open tibial shaft fracture (Orthopaedic Trauma Association classification 42A1, 4F2A; Gustilo classification type 1). On the day of injury, we performed osteosynthesis using a ring external fixator and primary closure of the open wound. Full weight-bearing was permitted from immediately after surgery. No significant complications were observed postoperatively, and the external fixator was removed 84 days postoperatively. No abnormal alignment of the lower leg, leg-length discrepancy or range of motion disorder was identified. To the best of our knowledge, no other reports have described use of a ring external fixator for open tibial shaft fractures in children with autism spectrum disorder. Using a ring external fixator appears helpful for open tibial shaft fractures in children who are unable to stay calm due to autism spectrum disorder, because there is no need to limit weight-bearing immediately after surgery. For Gustilo classification type 1 pediatric open fracture, primary closure of the open wound is safe after sufficient bone fixation.

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“…Circular external fixators, such as the Ilizarov external fixator, are used for treating open fractures, 1 limb lengthening, 2 and reconstruction after massive bone loss. 3 Complications associated with limb lengthening have been reported previously.…”

Section: B Ackgroundmentioning

confidence: 99%

Hybrid Fixation for Paediatric Femoral Supracondylar Fracture during Circular External Fixation of the Lower Limb

Oka¹,

Kim²,

Yoshida³

et al. 2020

Strategies in Trauma and Limb Reconstruction

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A bstract Aim To describe the novel hybrid fixation technique for paediatric femoral supracondylar fracture during circular external fixation of the lower limb. Background The Ilizarov external fixator is commonly used for various orthopaedic conditions. Difficulties associated with external fixation have previously been described. A fall while using a circular external fixator can cause ipsilateral fracture. Such fractures are ideally treated conservatively, but it is difficult to fix the frame itself. No study has reported the treatment of paediatric femoral supracondylar fracture during circular external fixation. Herein, we describe a novel hybrid fixation technique that was successfully used to treat paediatric femoral supracondylar fracture in three paediatric patients with circular external fixators. Technique The fracture was manually manipulated and reduced by slight hyperextension of the lower extremity under general anaesthesia. After confirmation of good reduction, a stockinette, a cast padding, and a thin core cast were applied to the ipsilateral thigh. The hinge parts were attached to the medial and lateral sides of the proximal ring. The rods were connected to the medial and lateral hinges, and the half ring was connected to the ventral side of the proximal end. Under fluoroscopic confirmation, the thin core cast of the thigh and rods were connected by cast rolled in a figure-of-eight manner. The hinges were locked with the knee joint slightly flexed. Conclusion The minimally invasive hybrid fixation technique enables conservative treatment of paediatric femoral supracondylar fracture during circular external fixation of the lower limb with no complications, and early exercise and recovery. Clinical significance This novel hybrid fixation technique will be an effective method for paediatric femoral supracondylar fracture in patients with a circular external fixator. How to cite this article Oka Y, Kim W-C, Yoshida T, et al. Hybrid Fixation for Paediatric Femoral Supracondylar Fracture during Circular External Fixation of the Lower Limb. Strategies Trauma Limb Reconstr 2020;15(3):179–183.

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Management of paediatric tibial fractures using two types of circular external fixator: Taylor spatial frame and Ilizarov circular fixator

Cited by 25 publications

References 20 publications

Clinical outcomes in pediatric tibial lengthening and deformity correction: A comparison of the Taylor Spatial Frame with the Orthex Hexapod System

Clinical outcomes in pediatric tibial lengthening and deformity correction: A comparison of the Taylor Spatial Frame with the Orthex Hexapod System

Open tibial shaft fracture in a boy with autism spectrum disorder treated using a ring external fixator: A case report

Hybrid Fixation for Paediatric Femoral Supracondylar Fracture during Circular External Fixation of the Lower Limb

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