A comparative study of clinical efficacy between early and late partial weight-bearing after taylor spatial frame external fixation for open tibial shaft fracture
A comparative study of clinical efficacy between early and late partial weight-bearing after taylor spatial frame external fixation for open tibial shaft fracture
赵启军 1张涛 2孙逊 2刘钊 2张宁宁 2梅晓龙 2贾鹏 2姚辉 2徐卫国 2王馨
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作者信息
1. 1天津医科大学骨科临床学院，天津 300211;2国药北方医院骨科，包头 014030
2. 3天津市天津医院矫形一病区，天津 300211
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摘要
目的 对比分析Taylor空间支架（TSF）外固定治疗胫骨干开放骨折患者术后早期部分负重与晚期部分负重的临床疗效。 方法 回顾性分析2018年1月至2020年6月在天津医院矫形一病区接受TSF治疗胫骨干开放骨折患者63例，依据术后开始部分负重时间的不同分为早期负重组（术后6周）和晚期负重组（术后10周）。终末随访时采用Johner-Wruhs胫骨干骨折疗效评定标准患肢功能。记录并比较两组患者TSF外架带架时间、完全负重时间及并发症发生情况。 结果 两组患者最终均骨折愈合，终末随访时早期负重组患肢功能优良率高于晚期负重组（83.33%比69.7%，Z=-2.072，P=0.038）。早期负重组TSF外架带架时间、完全负重时间均较晚期负重组短（均P<0.05）。 结论 与晚期部分负重相比，TSF外固定治疗胫骨干开放骨折患者术后早期、规律、持续、适度的部分负重能够促进骨折愈合，减少患者带架时间，有利于患肢机能快速恢复，具有临床应用价值及指导意义。 Objective This study aims to compare and analyze the clinical efficacy of early versus late partial weight-bearing in patients undergoing Taylor Spatial Frame (TSF) external fixation for open tibial shaft fracture. Methods 63 patients with open tibial shaft fractures treated with TSF between January 2018 and June 2020 in the Department of Orthopaedics Ward One of Tianjin Hospital were retrospectively studied. Based on the timing of initiating postoperative partial weight-bearing (PWB) , the patients were classified as the early weight-bearing group initiating PWB at 6 weeks postoperative and the late weight-bearing group initiating at 10 weeks postoperative. The limb function was evaluated using Johner and Wruh’s Criteria during the final follow-up. The duration of TSF application, time to full weight-bearing, and occurrence of complications were recorded and compared between the two groups. Results Both groups achieved fracture union. At the final follow-up, the early weight-bearing group exhibited a good-to-excellent rate of 83.33%, while the late weight-bearing group showed a good-to-excellent rate of 69.7%, suggesting a statistically significant difference between the two groups (Z=-2.072, P=0.038) . The early weight-bearing group had a shorter duration of TSF application and time to full weight-bearing compared with the late weight-bearing group, indicating statistically significant differences between the two groups (all P<0.05) . Conclusion Compared with late PWB, early, regular, continuous, and moderate PWB after TSF external fixation in patients with open tibial shaft fracture can promote fracture healing, reduce the duration of external fixation device usage, facilitate rapid functional recovery of the affected limb, thereby exhibiting clinical application value and guiding significance.
Abstract
Objective This study aims to compare and analyze the clinical efficacy of early versus late partial weight-bearing in patients undergoing Taylor Spatial Frame (TSF) external fixation for open tibial shaft fracture. Methods 63 patients with open tibial shaft fractures treated with TSF between January 2018 and June 2020 in the Department of Orthopaedics Ward One of Tianjin Hospital were retrospectively studied. Based on the timing of initiating postoperative partial weight-bearing (PWB) , the patients were classified as the early weight-bearing group initiating PWB at 6 weeks postoperative and the late weight-bearing group initiating at 10 weeks postoperative. The limb function was evaluated using Johner and Wruh’s Criteria during the final follow-up. The duration of TSF application, time to full weight-bearing, and occurrence of complications were recorded and compared between the two groups. Results Both groups achieved fracture union. At the final follow-up, the early weight-bearing group exhibited a good-to-excellent rate of 83.33%, while the late weight-bearing group showed a good-to-excellent rate of 69.7%, suggesting a statistically significant difference between the two groups (Z=-2.072, P=0.038) . The early weight-bearing group had a shorter duration of TSF application and time to full weight-bearing compared with the late weight-bearing group, indicating statistically significant differences between the two groups (all P<0.05) . Conclusion Compared with late PWB, early, regular, continuous, and moderate PWB after TSF external fixation in patients with open tibial shaft fracture can promote fracture healing, reduce the duration of external fixation device usage, facilitate rapid functional recovery of the affected limb, thereby exhibiting clinical application value and guiding significance.
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