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VOLUME 12 , ISSUE 1 ( April, 2017 ) > List of Articles

Original Article

A prospective observational study of 56 patients treated with ring fixator after a complex tibial fracture

Rasmus Elsoe, Søren Kold, Peter Larsen, Juozas Petruskevicius

Keywords : Ilizarov, Ring fixator, Complex fracture tibial bone, Plateau fracture, Pilon fracture, Short-term outcome

Citation Information : Elsoe R, Kold S, Larsen P, Petruskevicius J. A prospective observational study of 56 patients treated with ring fixator after a complex tibial fracture. 2017; 12 (1):35-44.

DOI: 10.1007/s11751-017-0275-9

License: CC BY-NC-SA 4.0

Published Online: 01-06-2015

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

The objective of this prospective study was to evaluate the patient-reported outcomes for patients with complex tibial fractures treated with a ring fixator. The secondary aim was to analyse the variables affecting patient-reported outcomes and time to union. Fifty-six patients participated in the study. The mean age at the time of fracture was 56.5 years (range 30–86). All fractures united during the study period. The ring fixator was removed at an average of 25.3 weeks (range 9–53). During treatment, the function and QOL increased with time. Compared with an established reference population, the study population showed a significantly worse EQ5D-5L index both throughout the treatment period and 8 weeks after frame removal. 18% of patients reported mild to severe depression 8 weeks after frame removal.


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  1. Joveniaux P, Ohl X, Harisboure A et al (2010) Distal tibia fractures: management and complications of 101 cases. Int Orthop 34:583-588
  2. Ramos T, Karlsson J, Eriksson BI, BINistor L (2013) Treatment of distal tibial fractures with the Ilizarov external fixator-a prospective observational study in 39 consecutive patients. BMC Musculoskelet Disord 14:30
  3. Krappinger D, Irenberger A, Zegg MHuber B (2013) Treatment of large posttraumatic tibial bone defects using the Ilizarov method: a subjective outcome assessment. Arch Orthop Trauma Surg 133:789-795
  4. Jansen H, Frey SP, Doht S et al (2013) Medium-term results after complex intra-articular fractures of the tibial plateau. J Orthop Sci 18:569-577
  5. Ali AM (2013) Outcomes of open bicondylar tibial plateau fractures treated with Ilizarov external fixator with or without minimal internal fixation. Eur J Orthop Surg Traumatol 23:349-355
  6. Manidakis N, Dosani A, Dimitriou R et al (2010) Tibial plateau fractures: functional outcome and incidence of osteoarthritis in 125 cases. Int Orthop 34:565-570
  7. Lee JA, Papadakis SA, Moon C, Zalavras CG (2007) Tibial plateau fractures treated with the less invasive stabilisation system. Int Orthop 31:415-418
  8. Ramos T, Ekholm C, Eriksson BI et al (2013) The Ilizarov external fixator-a useful alternative for the treatment of proximal tibial fractures. A prospective observational study of 30 consecutive patients. BMC Musculoskelet Disord 14:11
  9. Sament R, Mayanger JC, Tripathy SKSen RK (2012) Closed reduction and percutaneous screw fixation for tibial plateau fractures. J Orthop Surg (Hong Kong) 20:37-41
  10. Subasi M, Kapukaya A, Arslan H et al (2007) Outcome of open comminuted tibial plateau fractures treated using an external fixator. J Orthop Sci 12:347-353
  11. Baschera D, Kingwell D, Wren MZellweger R (2014) A holistic perspective of patients' lives post-Ilizarov external fixation. ANZ J Surg 84:776-780
  12. Kapoor SK, Kataria H, Patra SR, Boruah T (2010) Capsuloligamentotaxis and definitive fixation by an ankle-spanning Ilizarov fixator in high-energy pilon fractures. J Bone Joint Surg Br 92:1100-1106
  13. Alemdaroglu KB, Tiftikci U, Iltar S et al (2009) Factors affecting the fracture healing in treatment of tibial shaft fractures with circular external fixator. Injury 40:1151-1156
  14. Eq-5d questionnary (2012). http://www.euroqol.org/about-eq-5d/publications/user-guide.html
  15. Marsh JL, Slongo TF, Agel J, et al., (2007) Fracture and dislocation classification compendium—2007: orthopedic trauma association classification, database and outcome committee. J Orthop Trauma 21:1-133
  16. Wittrup-Jensen KU, Lauridsen J, Gudex C, Pedersen KM (2009) Generation of a Danish TTO value set for EQ-5D health states. Scand J Public Health 37:459-466
  17. Sorensen J, Davidsen M, Gudex C et al (2009) Danish EQ-5D population norms. Scand J Public Health 37:467-474
  18. KOOS questionnary [KOOS web site]. http://www.koos.nu. Accessed 12 June 2011
  19. Paradowski PT, Bergman S, Sunden-Lundius A et al (2006) Knee complaints vary with age and gender in the adult population. Population-based reference data for the Knee injury and Osteoarthritis Outcome Score (KOOS). BMC Musculoskelet Disord 7:38
  20. Olerud C, Molander H (1984) A scoring scale for symptom evaluation after ankle fracture. Arch Orthop Trauma Surg 103:190-194
  21. Olsen LR, Jensen DV, Noerholm V et al (2003) The internal and external validity of the Major Depression Inventory in measuring severity of depressive states. Psychol Med 33:351-356
  22. Bech P, Rasmussen NA, Olsen LR et al (2001) The sensitivity and specificity of the Major Depression Inventory, using the Present State Examination as the index of diagnostic validity. J Affect Disord 66:159-164
  23. Rasmussen PS (1973) Tibial condylar fractures. Impairment of knee joint stability as an indication for surgical treatment. J Bone Joint Surg Am 55:1331-1350
  24. Marsh JL, Buckwalter J, Gelberman R et al (2002) Articular fractures: does an anatomic reduction really change the result? J Bone Joint Surg Am 84-A:1259-1271
  25. Burwell HN, Charnley AD (1965) The treatment of displaced fractures at the ankle by rigid internal fixation and early joint movement. J Bone Joint Surg Br 47:634-660
  26. Ramos T, Ekholm C, Eriksson BI et al (2013) The Ilizarov external fixator-a useful alternative for the treatment of proximal tibial fractures. A prospective observational study of 30 consecutive patients. BMC Musculoskelet Disord 14:11
  27. Korkmaz A, Ciftdemir M, Ozcan M et al (2013) The analysis of the variables, affecting outcome in surgically treated tibia pilon fractured patients. Injury 44:1270-1274
  28. Ahearn N, Oppy A, Halliday R et al (2014) The outcome following fixation of bicondylar tibial plateau fractures. Bone Joint J 96-B:956-962
  29. Skoog A, Soderqvist A, Tornkvist H, Ponzer S (2001) One-year outcome after tibial shaft fractures: results of a prospective fracture registry. J Orthop Trauma 15:210-215
  30. O'Toole RV, Castillo RC, Pollak AN et al (2008) Determinants of patient satisfaction after severe lower-extremity injuries. J Bone Joint Surg Am 90:1206-1211
  31. Patel RA, Wilson RF, Patel PAPalmer RM (2013) The effect of smoking on bone healing: a systematic review. Bone Joint Res 2:102-111
  32. Adams CI, Keating JF, Court-Brown CM (2001) Cigarette smoking and open tibial fractures. Injury 32:61-65
  33. Demiralp B, Atesalp AS, Bozkurt M et al (2007) Spiral and oblique fractures of distal one-third of tibia-fibula: treatment results with circular external fixator. Ann Acad Med Singapore 36:267-271
  34. Smith TK, Reed JB, Sanders KM (1987) Interaction of two electrical pacemakers in muscularis of canine proximal colon. Am J Physiol 252:C290-C299
  35. Gaston P, Will E, McQueen MM et al (2000) Analysis of muscle function in the lower limb after fracture of the diaphysis of the tibia in adults. J Bone Joint Surg Br 82:326-331
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