Abstract: BACKGROUND: The trend in external fixator development is towards intelligence and miniaturization. Professor Qiao Feng of Xi'an Honghui Hospital designed a digital six-axis external fixator technology, based on CT data, which can accurately reduce fractures and is applied to lower limb fracture and orthopedic treatment, known as the Qiao’s spatial frame technology. Considering the large size of the digital six-axis external fixator, Professor Qiao Feng further developed a digital six-axis external fixator-assisted reduction and unilateral external fixator technology for the treatment of tibial shaft fractures. The developed unilateral external fixator is small in size, can be coupled with the six-axis external fixator, and is relatively less expensive than similar external fixators such as the Taylor spatial frame.
OBJECTIVE: To explore the effectiveness and reliability of digital six-axis external frame (Qiao’s spatial frame) assisted reduction and unilateral external fixator fixation for the treatment of tibial shaft fractures.
METHODS: A retrospective analysis was conducted on 103 patients with tibial shaft fractures treated with digital external fixators in the Department of Integrated Traditional Chinese and Western Medicine Orthopedics of Xi'an Honghui Hospital from January 2018 to December 2022. The cases were divided into a Qiao’s spatial frame group (n=51) and a Qiao’s spatial frame assisted reduction and unilateral external fixator fixation group (n=52). The displacement distance and angle of the fracture were measured on X-rays 4 weeks after reduction. Independent sample t test and chi-square test were used to compare fracture displacement, fracture healing time, lower extremity functional score and the incidence of pin tract complications.
RESULTS AND CONCLUSION: (1) There was no significant statistical difference in the displacement of the fracture 4 weeks after reduction between the Qiao’s spatial frame group and the Qiao’s spatial frame assisted reduction and unilateral external fixator fixation group (P > 0.05). (2) There was no significant statistical difference in the fracture healing time, lower extremity functional score and pin tract infection rate between the two groups (P > 0.05). (3) The pin tract traction pain in the Qiao’s spatial frame assisted reduction and unilateral external fixator fixation group was significantly reduced compared with the Qiao’s spatial frame group, with significant differences (15 cases versus 2 cases, P < 0.05). (4) It is indicated that Qiao’s spatial frame assisted reduction and unilateral external fixator fixation technology achieves anatomical reduction and stable fixation by coupling a Qiao’s spatial frame with a unilateral external fixator structure, significantly reducing the volume of traditional circular external fixators and reducing the incidence of needle tract complications, providing a minimally invasive and effective treatment option for closed and open tibial shaft fractures.

Key words: tibial shaft fracture, external fixator, digitalization, reduction, fixation