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Abstract：
OBJECTIVE: This study aimed to compare the clinical effectiveness of intramedullary nailing (IMN), percutaneous external plate fixation (PEPF), and re-applied external fixation (REF) in the treatment of refracture at the consolidated docking site following the removal of external fixation in patients with tibial defects who had previously undergone the Ilizarov bone transport technique.
METHODS: A retrospective review was performed on patients who received IMN, PEPF, or REF for refracture at the consolidated docking site subsequent to the removal of external fixation. A collection of data was made regarding the following parameters: age, gender, defect size, treatment methods, external fixation time (EFT), external fixation index (EFI), time of refracture (TOR) subsequent to fixation removal, and docking reunion time (DRT). Bone and functional outcomes were evaluated by the Association for the Study and Application of the Method of Ilizarov (ASAMI) scoring system and the Lower Extremity Functional Scale (LEFS) questionnaire.
RESULTS: The study included 14 males and 5 females with an average age of 38.1 ± 8.9 years (range, 26 to 55 years). Etiologies included post-traumatic osteomyelitis in 11 cases and post-traumatic bone loss in 8 cases. The median bone defect was 5.11 ± 0.87 cm (range, 3.8 to 6.8 cm). Following docking site refracture, 6 cases were treated with IMN, 8 with PEPF, and 5 with REF. All patients achieved both satisfactory bone union and functional outcomes, and there was no significant difference in preoperative baseline data or postoperative outcomes among the three groups.
CONCLUSIONS: IMN, PEPF, and REF were all demonstrated favorable postoperative bone and functional outcomes, suggesting their reliability as treatment options for managing docking site refracture following external fixation removal.
METHODS: A retrospective review was performed on patients who received IMN, PEPF, or REF for refracture at the consolidated docking site subsequent to the removal of external fixation. A collection of data was made regarding the following parameters: age, gender, defect size, treatment methods, external fixation time (EFT), external fixation index (EFI), time of refracture (TOR) subsequent to fixation removal, and docking reunion time (DRT). Bone and functional outcomes were evaluated by the Association for the Study and Application of the Method of Ilizarov (ASAMI) scoring system and the Lower Extremity Functional Scale (LEFS) questionnaire.
RESULTS: The study included 14 males and 5 females with an average age of 38.1 ± 8.9 years (range, 26 to 55 years). Etiologies included post-traumatic osteomyelitis in 11 cases and post-traumatic bone loss in 8 cases. The median bone defect was 5.11 ± 0.87 cm (range, 3.8 to 6.8 cm). Following docking site refracture, 6 cases were treated with IMN, 8 with PEPF, and 5 with REF. All patients achieved both satisfactory bone union and functional outcomes, and there was no significant difference in preoperative baseline data or postoperative outcomes among the three groups.
CONCLUSIONS: IMN, PEPF, and REF were all demonstrated favorable postoperative bone and functional outcomes, suggesting their reliability as treatment options for managing docking site refracture following external fixation removal.
摘要：
目的：本研究旨在比较髓内钉（IMN）的临床疗效，经皮钢板外固定术(PEPF),并在先前接受过Ilizarov骨运输技术的胫骨缺损患者移除外固定支架后，重新应用外固定支架（REF）治疗合并对接部位的再骨折。
方法：对接受IMN，PEPF,或REF用于在移除外固定架后在合并的对接部位再骨折。收集了有关以下参数的数据：年龄，性别,缺陷尺寸,治疗方法,外固定时间（EFT），外固定指数(EFI),内固定移除后的再骨折时间（TOR），和对接团聚时间(DRT)。通过Ilizarov方法研究与应用协会（ASAMI）评分系统和下肢功能量表（LEFS）问卷评估骨和功能结果。
结果：该研究包括14名男性和5名女性，平均年龄为38.1±8.9岁（范围，26至55岁）。病因包括创伤后骨髓炎11例，创伤后骨丢失8例。正中骨缺损为5.11±0.87cm(范围,3.8至6.8厘米）。对接部位再骨折后，6例采用IMN治疗，8与PEPF，5带REF所有患者均获得了满意的骨愈合和功能结局。三组之间的术前基线数据或术后结局无显著差异。
结论：IMN，PEPF,和REF均显示良好的术后骨和功能结局，提示其作为外固定支架移除后对接部位再骨折治疗方案的可靠性。
方法：对接受IMN，PEPF,或REF用于在移除外固定架后在合并的对接部位再骨折。收集了有关以下参数的数据：年龄，性别,缺陷尺寸,治疗方法,外固定时间（EFT），外固定指数(EFI),内固定移除后的再骨折时间（TOR），和对接团聚时间(DRT)。通过Ilizarov方法研究与应用协会（ASAMI）评分系统和下肢功能量表（LEFS）问卷评估骨和功能结果。
结果：该研究包括14名男性和5名女性，平均年龄为38.1±8.9岁（范围，26至55岁）。病因包括创伤后骨髓炎11例，创伤后骨丢失8例。正中骨缺损为5.11±0.87cm(范围,3.8至6.8厘米）。对接部位再骨折后，6例采用IMN治疗，8与PEPF，5带REF所有患者均获得了满意的骨愈合和功能结局。三组之间的术前基线数据或术后结局无显著差异。
结论：IMN，PEPF,和REF均显示良好的术后骨和功能结局，提示其作为外固定支架移除后对接部位再骨折治疗方案的可靠性。
