Abstract：
OBJECTIVE: Bone transport has become the gold standard for treating large segmental tibial bone defects. The technique for application the Ilizarov circular fixator (ICF) has a long learning curve and is associated with many complications. There are few clinical studies on bone transport via the Taylor spatial frame (TSF). The main purpose of this study was to compare the radiological and clinical and outcomes of bone transport by using the TSF and the ICF.
METHODS: There were 62 patients included in this retrospective study from June 2011 to June 2021 and distributed to two groups according to the fixation method: a TSF group consisting of 30 patients and an ICF group consisting of 32 patients. Demographic information, surgical duration, external fixation times, external fixation index, final radiographic results, complications, and clinical outcomes were recorded and examined. The clinical outcomes were assessed using the ASAMI criteria during the most recent clinical visit. Then, statistical analysis such as independent-samples t tests or chi-Square test was performed.
RESULTS: The mean surgical duration in the TSF group was 93.8 ± 7.3 min, which was shorter than that in the ICF group (109.8 ± 1.4 min) (p < 0.05). Compared to the ICF group (10.2 ± 2.0 months), the TSF group (9.7 ± 1.8 months) had a shorter average external fixation time (p > 0.05). The external fixation index was 1.4 ± 0.2 m/cm and 1.5 ± 0.1 m/cm in the two groups. Moreover, there was no significant difference between the two groups. At the last follow-up visit, the medial proximal tibial angle (MPTA) and posterior proximal tibial angle (PPTA) in the TSF group were 88.1 ± 12.1° and 80.9 ± 1.3°, respectively. The MPTA and PPTA in the ICF group were 84.4 ± 2.4° and 76.2 ± 1.9°, respectively. There were statistically significant differences between the two groups (all p < 0.05). The complication rate was 50% in the TSF group and 75% in the ICF group. Moreover, the ASAMI score between the two groups was no statistically significant difference (p > 0.05).
CONCLUSIONS: No statistically significant difference was found in clinical outcomes between the use of Taylor spatial frame and Ilizarov circular fixator for treating large segmental tibial bone defects. However, TSF is a shorter and simpler procedure that causes fewer complications and improves limb alignment.
METHODS: There were 62 patients included in this retrospective study from June 2011 to June 2021 and distributed to two groups according to the fixation method: a TSF group consisting of 30 patients and an ICF group consisting of 32 patients. Demographic information, surgical duration, external fixation times, external fixation index, final radiographic results, complications, and clinical outcomes were recorded and examined. The clinical outcomes were assessed using the ASAMI criteria during the most recent clinical visit. Then, statistical analysis such as independent-samples t tests or chi-Square test was performed.
RESULTS: The mean surgical duration in the TSF group was 93.8 ± 7.3 min, which was shorter than that in the ICF group (109.8 ± 1.4 min) (p < 0.05). Compared to the ICF group (10.2 ± 2.0 months), the TSF group (9.7 ± 1.8 months) had a shorter average external fixation time (p > 0.05). The external fixation index was 1.4 ± 0.2 m/cm and 1.5 ± 0.1 m/cm in the two groups. Moreover, there was no significant difference between the two groups. At the last follow-up visit, the medial proximal tibial angle (MPTA) and posterior proximal tibial angle (PPTA) in the TSF group were 88.1 ± 12.1° and 80.9 ± 1.3°, respectively. The MPTA and PPTA in the ICF group were 84.4 ± 2.4° and 76.2 ± 1.9°, respectively. There were statistically significant differences between the two groups (all p < 0.05). The complication rate was 50% in the TSF group and 75% in the ICF group. Moreover, the ASAMI score between the two groups was no statistically significant difference (p > 0.05).
CONCLUSIONS: No statistically significant difference was found in clinical outcomes between the use of Taylor spatial frame and Ilizarov circular fixator for treating large segmental tibial bone defects. However, TSF is a shorter and simpler procedure that causes fewer complications and improves limb alignment.
摘要：
目的：骨转运已成为治疗胫骨大段骨缺损的金标准。应用Ilizarov圆形固定器（ICF）的技术具有较长的学习曲线，并且与许多并发症有关。关于通过泰勒空间框架（TSF）的骨运输的临床研究很少。这项研究的主要目的是通过使用TSF和ICF比较骨运输的放射学和临床以及结果。
方法：本回顾性研究于2011年6月至2021年6月纳入62例患者，根据固定方法分为两组：TSF组30例，ICF组32例。人口统计信息,手术时间,外固定次数,外固定指数,最终射线照相结果，并发症,记录和检查临床结局.在最近的临床访视期间使用ASAMI标准评估临床结果。然后，进行独立样本t检验或卡方检验等统计分析。
结果：TSF组的平均手术时间为93.8±7.3分钟，短于ICF组(109.8±1.4min)(p<0.05)。与ICF组相比（10.2±2.0个月），TSF组平均外固定时间(9.7±1.8个月)较短(p>0.05)。两组外固定指数分别为1.4±0.2m/cm和1.5±0.1m/cm。此外，两组间差异无统计学意义。在最后一次后续访问中，TSF组胫骨内侧近端角(MPTA)和胫骨后侧近端角(PPTA)分别为88.1±12.1°和80.9±1.3°,分别。ICF组的MPTA和PPTA分别为84.4±2.4°和76.2±1.9°,分别。两组间差异均有统计学意义(均p<0.05)。TSF组为50%,ICF组为75%。此外，两组间ASAMI评分差异无统计学意义(p>0.05)。
结论：在使用Taylor空间框架和Ilizarov圆形固定器治疗大段胫骨骨缺损的临床效果上没有发现统计学上的显著差异。然而,TSF是一种更短，更简单的程序，可减少并发症并改善肢体对准。
方法：本回顾性研究于2011年6月至2021年6月纳入62例患者，根据固定方法分为两组：TSF组30例，ICF组32例。人口统计信息,手术时间,外固定次数,外固定指数,最终射线照相结果，并发症,记录和检查临床结局.在最近的临床访视期间使用ASAMI标准评估临床结果。然后，进行独立样本t检验或卡方检验等统计分析。
结果：TSF组的平均手术时间为93.8±7.3分钟，短于ICF组(109.8±1.4min)(p<0.05)。与ICF组相比（10.2±2.0个月），TSF组平均外固定时间(9.7±1.8个月)较短(p>0.05)。两组外固定指数分别为1.4±0.2m/cm和1.5±0.1m/cm。此外，两组间差异无统计学意义。在最后一次后续访问中，TSF组胫骨内侧近端角(MPTA)和胫骨后侧近端角(PPTA)分别为88.1±12.1°和80.9±1.3°,分别。ICF组的MPTA和PPTA分别为84.4±2.4°和76.2±1.9°,分别。两组间差异均有统计学意义(均p<0.05)。TSF组为50%,ICF组为75%。此外，两组间ASAMI评分差异无统计学意义(p>0.05)。
结论：在使用Taylor空间框架和Ilizarov圆形固定器治疗大段胫骨骨缺损的临床效果上没有发现统计学上的显著差异。然而,TSF是一种更短，更简单的程序，可减少并发症并改善肢体对准。
