[Biomechanics of the external fixation clamps].
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Biomedical subjects
Publications and source records attributed to R Labitzke.
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The tensions caused by means of flexors and tensors on the intact and by various procedures operated fractured patella have been determined. The disadvantages of the cerclage and the eccentric ventral tension band, both of them mainly usual, are exposed. Interfragmentary measurements of pression power in a corpse knee as well as breaking tests with a model patella and first experiences by operation with a new method confirm the reflexions. Principles for a modus of osteosynthesis for fractures of the patella are realized by the lateral tension-band. All loading inclined fragment distractive powers thereby are taken up by production a high-level interfragmentary compression, so that immediate postoperative loading is possible.
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By means of compression plate osteosynthesis, of the lateral tension band and of the treatment with external chucks the main demand for stability of osteosynthesises is derivated: by adjustified, in the resultant axial tension of the metal implantats is to produce only pressure in the entire fracture zone without detrimental osteosynthesis induced excentric powers. The joint biomechanic aspects of the three methods are worked out.
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This is the analysis of external forces acting on the elbow joint and their influence on the appearance of bending forces, shearing forces and tensions along the ulna and their alterations with fractures of the olecranon. The influence of flexor muscles on the fracture site is being evaluated too. The fracture of the olecranon is being defined by means of statics. All disadvantages of a dorsal tension band i.e. uncertainty to neutralize all forces acting at the fracture site adequately, irregular interfragmentary compression, creation of unwanted stearing forces and moments, rest on its excentric localisation. The optimal distribution of hard ware is being evaluated.
The lateral tension band generates continuous interfragmentary compression through two wires alongside the ulna. Without loss of compressive forces this procedure can be applied to proximal ulna shaft fractures which until now have been considered among fractures of the olecranon because the flexion forces at the fracture site are neutralized. Fractures of the patella are the second main indication for this procedure. All disadvantages of the "classical" dorsal tension band are being avoided by centric compression.
Previous experiments with dorsal or lateral tension band have been tested and confirmed on model bone. The lateral tension band is superior to the dorsal because it can neutralize all forces across the fracture site without creation of unwanted adverse forces.
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It is reported on a septennial observation of a 43 year old woman, who was admitted to the hospital in 1968 with at first unclear symptoms and who developed an azotemia within a few days. The infusion pyelogram showed a hydronephrosis with enlargement of the upper part of the ureter; the lower part of the ureter was normal. After displacement of the ureters out of the fibrotic clasping into a duplicate of the peritoneum, the urine flow has normalized. After 7 years the patient is now healthy and able to work. The cause of the urinary stasis was histologically cleared as retroperitoneal fibrosis.
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