Enhanced Radiographic Union Score (RUST) of Adolescent Tibia Shaft Fractures Treated with Hexapod Circular External Fixation: A Multicenter Study of 38 Consecutive Cases
Ali M. Maziad, Soyoung Jeon, Anirejuoritse Bafor, Dillon Stone, Amr Abdelgawad, Christopher Iobst, Ahmed ThabetAbstract
Purpose:
Tibial fractures in skeletally immature patients are challenging to treat. The circular hexapod external fixator (CHEF) allows immediate weightbearing, early range of motion, and software to adjust post-operative alignment. This study aimed to evaluate outcomes and cost for adolescent tibia shaft fractures treated with CHEF.
Methods:
This was an IRB-approved, multicenter, retrospective case-series of tibial shaft fractures treated with CHEF in patients aged 10-17 years-old from 2010-2021. Patient demographics, radiographic data, and financial data were investigated.
Results:
Thirty-eight cases were included. Mean age was 14 years. Average treatment duration was 4 months with 7 months mean follow-up. Twelve (31%) were open fractures and 21 (55%) developed pin site infections. All fractures healed with <10 degrees of deviation in all planes. Open fractures were associated with higher energy mechanisms (
Conclusion:
CHEF’s were shown to provide full weightbearing and early range of motion with minimal complications. Pin site infections were the most common complication and correlated positively with secondary procedures. CHEF’s allowed minimal angulation or translation with no cases of nonunion.
Significance of Study:
Largest case-series on CHEF use in adolescent patients displaying high success rates with minimal complications and an exploratory study on the RUST tool in pediatric patients.