Effects of external fixation as a terminal versus staged treatment on prognosis in patients with open tibiofibular fracture
10.3760/cma.j.cn115530-20191208-00447
- VernacularTitle:胫腓骨开放性骨折外固定支架分期治疗和终末治疗对患者预后的影响
- Author:
Qian WANG
1
;
Yao LU
;
Teng MA
;
Cheng RENG
;
Ming LI
;
Kun ZHANG
;
Zhong LI
Author Information
1. 西安交通大学医学院附属红会医院创伤骨科下肢病区 710054
- From:
Chinese Journal of Orthopaedic Trauma
2020;22(4):286-291
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effects of external fixation as a terminal versus staged treat-ment on the health-related quality of life and function in patients with open tibiofibular fracture.Methods:From March 2017 to October 2018, 52 patients with open tibiofibular fracture were admitted to Department of Orthopaedic Surgery, Honghui Hospital.They were 37 males and 14 females, aged from 19 to 62 years(mean, 39.9 years).They were assigned into 2 groups subjected to 2 different treatment plans.In group A of 35 cases primary external fixation was replaced by terminal internal fixation while in group B of 17 cases primary ex-ternal fixation continued to the end.The 2 groups were compared in terms of the physiological total score (PCS) and mental component summary (MCS) in the 12-item short-form health survey (SF-12) at 1, 3, 6, 9 and 12 months postoperation, fracture healing time, time for external fixation, incidence of complications, and the lower extremity functional scale (LEFS).Results:The 2 groups were compatible due to insignificant differences in the general clinical data ( P>0.05).The follow-ups for the 2 groups were all beyond 12 months.PCS and MCS peaked both at 12 months postoperation in group A, but peaked respectively at 6 and 3 months postoperation in group B.Compared with group B, group A showed significantly higher PCS and MCS at 6, 9 and 12 months postoperation, significantly shorter fracture healing time (19.2 weeks ± 4.6 weeks versus 23.3 weeks ± 5.6 weeks), significantly shorter time for external fixation (15.6 days ± 4.2 days versus 270.0 days ± 15.4 days), significantly lower incidence of complications[5.7%(2/35) versus 35.3%(6/17)], significantly higher LEFS scores (88.3±7.2 versus 78.5 ± 5.2), and significantly higher the excellent and good rate by the Johner-Wruh scoring [94.3%(33/35) versus 70.6%(12/17)] (all P< 0.05). Conclusion:Compared with external fixation as a terminal treatment, external fixation followed by internal fixation can significantly improve the health-related quality of life and function in patients with open tibiofibular fracture and effectively reduce the incidence of postoperative complications.
