微生物および生化学技術ジャーナル

概要

Clinical Outcomes of Conversion Surgery from an External Fixator to an Iodine-Supported Titanium Alloy Plate

Hidenori Matsubara, Toshiharu Shirai, Koji Watanabe, Issei Nomura and Hiroyuki Tsuchiya

Background: External fixators brought a revolution in orthopaedic surgical treatment after the invention of distraction osteogenesis, which enabled treatment of various difficult diseases. However, they had some drawbacks, such as pin-site infections, psychological pain, and refracture after removal. To overcome these problems, many efforts have been made by shortening of the period of wearing them. One of those methods is conversion to locking plate, which had high risk of infection. To reduce the risk of infection, we performed conversion surgery using iodinesupported titanium plate (We named it iPlates, developed at our department). Questions/purposes: We therefore evaluated (1) Operation time, (2) whether bone union was achieved, (3) blood biochemistry, including thyroid hormone levels, (4) post-surgical complications. Patients and Methods: We assessed 28 legs. There were 13 legs after deformity correction and limb lengthening, three legs with pseudarthrosis after bone fracture, two legs after bone transport, one leg after shortening distraction, and one leg after open fracture. The mean follow-up period was 24.5 months. Results: Average operation time was 197 minutes. Bone union was achieved in all cases. Blood examinations did not find any abnormalities due to iImplant implantation, such as with thyroid hormones. One patient had superficial soft tissue infection treated with re-operation without removal of plate. Conclusions: An iPlate can reduce complications compare to previous studies. Conversion surgery with iPlate could be a new path for the future of external fixation.