Carefix hexaxial spatial frame versus Ilizarov circular external fixator in treating high-energy tibial shaft fractures：a retrospective study

Abstract Background: External fixation has become an effective technique for treating the high-energy tibial shaft fractures (HETSFs) , which is usually accompanied by significant surrounding soft tissue damage. This study aimed to explore the differences of clinical outcomes of HETSFs with the treatment of Carefix hexaxial spatial frame (CHSF) or Ilizarov circular external fixator (ICEF). Methods: 46 patients suffering HETSFs that were treated between January 2019 and July 2022 by CHSF or ICEF were divided into two groups: CHSF group and ICEF group. There were 38 males and 8 females with age range of 20 to 65 years. The characteristics data, operation time, external fixation time, bone union time, final radiological outcomes, complications and clinical outcomes were recorded. The minimum follow-up was 12 months.The clinical outcomes were evaluated by the Association for the Study and Application of the Method of Ilizarov criteria (ASAMI) at the final follow-up. Results: 46 patients with HETSFs were evaluated, including 26 patients in CHSF group and 20 patients in ICEF group in this study. The mean operation time in CHSF group (85.9±11.5 min) was shorter than that in ICEF group (95.8±4.2 min) (P<0.001). All patients achieved complete bone union. Mean external fixation time was (26.0±3.8) weeks for CHSF group and (26.5±4.1weeks) for ICEF group (P>0.05). Translation and angulation in lateral view for CHSF group were all less than that for ICEF group (P<0.001). At the final follow-up, no significant differences were found between the two groups concerning the ASAMI scores and complication rate (P>0.05). Conclusion: In terms of final clinical outcomes, there is no statistically significant difference between CHSF and ICEF in treating HETSFs. Nevertheless, CHSF is superior to ICEF in aspects of operation time and tibial fracture reduction.