Risk factors for axial deviation in treatment of tibial bone defects by bone transport with Orthofix unilateral external fixator
10.3760/cma.j.cn115530-20220125-00050
- VernacularTitle:Orthofix单边外固定支架骨搬运治疗胫骨缺损中发生轴向偏移的危险因素分析
- Author:
Dongwei FENG
1
;
Yaxin ZHANG
;
Yanshi LIU
;
Xuefeng LUO
;
Erlin CHENG
;
Qiyu JIA
;
Dongsheng CHEN
;
Jian GUO
;
Chuang MA
Author Information
1. 新疆医科大学第一附属医院骨科中心显微修复外科，乌鲁木齐 830054
- Keywords:
Tibia;
Bone defects;
External fixators;
Ilizarov technique;
Axial deviation;
Risk factors
- From:
Chinese Journal of Orthopaedic Trauma
2022;24(6):471-477
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors for axial deviation in the treatment of tibial defect susing Orthofix unilateral external fixator and proximal tibial osteotomy for bone transport.Methods:A retrospective study was performed to analyze the clinical data of 90 patients who had been treated for tibial bone defects by the Orthofix unilateral external fixator at Department of Microrepair and Reconstruction, The First Hospital Affiliated to Xinjiang Medical University from May 2012 to June 2019. There were 77 males and 13 females with a mean age of 41.2 years (from 17 to 63 years).The bone defects ranged from 4 to 13 cm in length. According to the Paley criteria for axial deviation, the 90 patients were divided into 2 groups: a deviation-free group with no axial deviation or an axial deviation ≤5° and a deviation group with an axial deviation>5°. The 2 groups were compared in terms of age, number of prior surgery, defect length, placement angle of Schanz screws, external fixation time, external fixation index and bending degree of Schanz screws at the last follow-up.The factors with P<0.05 were analyzed by multivariate logistic regression to find the risk factors for coronal axial deviation. Results:The 90 patients were followed up for an average of 23 months (from 12 to 40 months). The incidence of axial deviation in this cohort was 36.7% (33/90).The deviation group had a significantly larger number of prior surgery [5 (3, 6) times], a significantly longer defect length [8 (8, 9) cm], a significantly longer external fixation time [400.0 (341.8, 426.3) d], and a significantly greater bending degree of Schanz screws at the last follow-up [1.2° (0.4°, 3.5°)] than the deviation-free group [3 (2, 3) times, 6 (5, 8) cm, 340.8 (226.5, 422.8) d, and 0.8° (0.2°, 3.7°)] (all P<0.05). Multivariate logistic regression analysis showed that the number of prior surgery ( OR=2.581, 95% CI: 1.496-4.450, P=0.001) and the defect length ( OR=5.310, 95% CI: 1.952-14.442, P=0.001) were the risk factors for the axial deviation. Conclusion:In the treatment of tibial defect susing Orthofix unilateral external fixator and proximal tibial osteotomy for bone transport, the more prior surgeries and the longer a bone defect, the higher the risk for axial deviation.
