Clinical outcomes of Taylor spatial frame versus intramedullary nailing in treating middle and lower tibial fractures
Objective:To compare the clinical outcomes of Taylor spatial frame and intramedullary nailing in the treatment of middle and lower tibial fractures.Methods:A retrospective analysis was conducted on the clinical data of 79 patients with middle and lower tibial fractures treated at Tianjin Hospital from August 2016 to December 2019.Patients were divided into two groups:41 treated with Taylor spatial frame(external fixation group)and 38 treated with intramedullary nailing(intramedullary nailing group).The operative indicators and fracture healing time were compared between the two groups.Clinical outcomes,including fracture healing,range of motion of knee and ankle joints,pain scores in the knee and ankle joint,and functional recovery of the affected limb were assessed at 6 weeks,3 months,6 months and 1 year postoperatively,and incidence of complications was assessed at 1 year postoperatively.Results:Compared with the intramedullary nailing group,the external fixation group had significantly shorter operative time,faster fracture healing,and less intraoperative blood loss(all P<0.05).There was no statistically significant difference in hospital stay between the two groups(P>0.05).At 6 weeks post-surgery,the external fixation group showed superior knee joint range of motion compared to the intramedullary nailing group(P<0.05),with no significant differences observed at 3 months,6 months,and 1 year post-surgery(all P>0.05).The external fixator group had a significantly lower ankle joint range of motion at 6 weeks,3 months,and 6 months postoperatively compared to the intramedullary nail group(all P<0.05),but not at 1 year postoperatively(P>0.05).The median VAS scores for the knee joint were significantly lower in the external fixator group at all follow-up points(all P<0.05),while there were no statistically significant differences in the VAS scores for the ankle joint(all P>0.05).AOFAS scores for the affected limb were lower in the external fixator group than in the intramedullary nail group at 3 months and 6 months postoperatively(all P<0.05),with no significant differences at 6 weeks and 1 year post-surgery between the two groups(all P>0.05).The excellent rates of the AOFAS scores were similar between the groups at 1 year postoperatively(all P>0.05).At 6 months post-surgery,the satisfaction rate was significantly lower in the external fixation group than in the intramedullary nail group(P<0.05),with no statistically significant differences at 6 weeks,3 months or 1 year postoperatively(all P>0.05).The overall complication rate was similar between the groups(P>0.05).Conclusions:Both Taylor spatial frame and intramedullary nailing can achieve excellent clinical outcomes in the treatment of middle and lower tibial fractures.However,the Taylor spatial frame has advantages such as a shorter operative time,less intraoperative blood loss,faster fracture healing,and reduced postoperative knee joint pain,making it a preferable treatment option for middle and lower tibia fractures.
Tibial FractureExternal FixatorIntramedullary Nail FixationFracture Fixation
万方数据
维普
