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At least 19 recordsLinked to original sources
PubMed1992

[Stabilizing the open fracture with the external fixator].

External fixation plays a major role in contemporary trauma care. Indications are not limited to the obviously open fracture but also to cases with severe "closed" soft tissue injuries (contusions, burns etc.). The technique is reviewed and importance of pin placement, fixator geometry, minimal internal fixation and staged fixator removal are stressed. The modern external fixation techniques may be used to obtain bony union or they may be used temporarily switching to definitive internal fixation upon obtention of soft tissue healing.

External Fixators↗
PubMed1992

Instrumentation for external fixation.

External skeletal fixation is a very useful technique for managing many orthopedic problems in veterinary practice. The Kirschner apparatus has been the most widely used fixator for many years in veterinary orthopedics because of its versatility, simplicity, and economy in use. The medium-sized device has the widest indications and is easiest to begin with. The small size can be acquired later for use on cats and small dogs. The new "raised thread" fixation pin designs improve bone-pin integrity and can be used in combination with nonthreaded pins to decrease the incidence of postoperative complications and for economy. Acrylic-pin external fixators are particularly useful for treatment of mandibular fractures and transarticular application since they allow nonlinear placement of fixation pins in highly contoured bones. A commercial system, currently being developed, will have all the equipment and materials necessary for their application in a convenient kit. Circular fixators (Ilizarov design) use thin K wires placed under tension to replace rigid fixation pins. Their unique adjustability characteristics make them useful in the treatment of limb deformity and shortening. Many other human fixators can be used for veterinary application if the basic principles of fixators are followed. Instrumentation required for external fixator application include a pin driver, pin cutter, and wrenches. Although surgical versions of these materials are available, less expensive alternatives are available using gas sterilization instead of autoclaving. The use of selected orthopedic instrumentation such as a periosteal elevator, bone clamps, and curets will facilitate fracture management.

Animals↗
PubMed1990

[Method of fracture fixation using external fixation devices].

An improvement of the results of treatment can be reached, beside respecting the indication of external fixateurs, with correct tactics of the treatment. Because of the disadvantages of the fixateur externe, we strive to restrict their use, to the time by all means necessary, and if possible to use other methods of fixation. This is motivated especially by the effect on fracture healing and the hindering of the movements and activity of the patient.

Biomechanical Phenomena↗
PubMed1976

[High tibial osteotomy--fixation by means of external fixation--indication, technique, complications (author's transl)].

High tibial osteotomy has proved its value in the treatment of gonarthrosis with or without axis deformity. The thrust of weight-bearing and other stresses is lessened on the degenerated tibial condyle and transferred to the more normal condyle. The stable fixation by means of external fixation allows early movement of the knee joint.-R-ferences to operative technique, indication, complications and after-treatment.

Arthrodesis↗
PubMed1992

Biomechanics of the Ilizarov external fixator.

The Ilizarov external fixator exhibits more isotropic mechanical properties in bending and nonlinear axial stiffness than do unilateral and bilateral external fixators. Each frame element--wire size, tension, and orientation, as well as ring type--contributes to overall frame rigidity and stability. These factors and the specific clinical situation must be considered for the successful application of the Ilizarov fixator.

Biomechanical Phenomena↗
PubMed1991

The role of supplemental lag-screw fixation for open fractures of the tibial shaft treated with external fixation.

Ninety-nine open fractures of the tibial shaft were treated with unilateral external fixation with or without supplemental lag-screw fixation. We compared the results in forty-four fractures in which only external fixation was used (control group) with those in fifty-five fractures that were stabilized with lag-screws and external fixation, and we found no statistically significant differences between the two groups with respect to the time to full weight-bearing, the time to union, or the rates of delayed union, osteomyelitis, malunion, superficial or deep pin-track infection, or loosening of the pins. The limbs in which the fracture was treated with external fixation and supplemental lag-screws had more than twice the rate of refracture of the control limbs (11 compared with 5 per cent), and the percentage of fractures having supplemental lag-screw fixation that needed bone-grafting to achieve union was more than twice that in the group treated with external fixation alone. We concluded that the routine use of supplemental lag-screw fixation is not indicated in patients who have an open fracture of the tibial shaft that has been stabilized with external fixation.

Adolescent↗
PubMedDate not supplied

The child with an Ilizarov external fixator.

The Ilizarov External Fixator is gaining popularity as the most effective method to correct limb length deficiencies, correct angular deformities, and aid in the restoration of a limb compromised by traumatic injuries. Nurses caring for a child having this procedure need an understanding of the device application and appropriate nursing strategies.

Adolescent↗
PubMed1992

Classification and nomenclature of external fixators.

Classification of external fixators has graduated from simple device names to a more descriptive system based on frame configuration. Fixators are of the simple pin, clamp, or ring type. Two classification systems are currently being used to categorize fixators. In one, they are defined as type I, type II, or type III fixators. In the second classification system, the categories are more descriptive. Fixators are broadly defined either as unilateral or bilateral. Within each of these categories, there are one-plane or two-plane frames. In veterinary orthopedics, further adjectives, such as double-clamp, single-bar, two-pin single-bar, and double-bar, are employed to describe some of the more popular configurations. Many configurations are not easily definable because complex arrangements of pins and clamps are sometimes necessary to adapt the frame to the fracture bone successfully.

Animals↗
PubMed1992

External fixator pin design.

The integrity of the bone-pin interface is the critical link in the stability of external fixation systems. External fixation pins placed in cancellous metaphyseal bone frequently loosen over time, resulting in fixation failure and an increased risk of infection. To design an external fixation pin with optimal bone-metal interface strength in cancellous bone, a systematic study of various thread design features was performed. Combinations of pitch, tooth profile, and minor diameter in 5 mm self-tapping half pins were evaluated in coaxial pullout testing using a fresh bovine cancellous bone. A significant increase in pullout strength was found with a decrease in minor diameter. No statistical differences were found in pullout strength attributable to thread profile and pitch. There were no significant interactions between minor diameter and tooth profile or minor diameter and pitch. The data obtained suggest significantly greater holding power in cancellous bone can be achieved by using an external fixation pin with a smaller minor diameter or a larger interference. Additional pullout testing of five commercially available external fixator pins was performed. Of these, the two pins with the largest interference demonstrated greater pullout strength. Therefore, within a range of acceptable major diameters and adequate minor diameters for the torsional strength requirements, an optimal interference for cancellous pin application may exist and it may well be larger than that present in currently available external fixation pins.

Animals↗
PubMed1976

External fixation in maxillofacial surgery.

The role of external fixation in the treatment of facial fractures is well defined. If standard open reduction and internal fixation techniques do not yield a satisfactory result, external fixation techniques may be required. Open reduction has the advantage of effecting precise approximation of fragments. However, this type of fixation may be inadequate, either because no stable point is available or because the angle of traction involved in fixation may result in displacement of the reduced fracture and subsequent malunion. When the facial skeleton is fractured, it tends to collapse inward, and if injury is severe, an external traction point anterior, lateral, or superior to the facial skeleton may be required to obtain a satisfactory result. There are occasions when intermaxillary fixation may be inadvisable, and in these instances external fixation techniques may be an appropriate means of immobilization. Finally external fixation techniques may be required in instances in which massive tissue loss precludes the use of standard open reduction and internal fixation techniques. It must be reemphasized that the methods of external fixation described here are not meant to supplant the standard techniques of open reduction and interosseous wiring, but when judicially employed complement them in achieving the desired result of precise reduction and firm fixation of the fractured facial skeleton.

Fracture Fixation↗
PubMed1991

External fixation of metacarpal and phalangeal fractures.

External fixation is rarely employed in the treatment of hand fractures, and few reports describing this technique have been published. This is a report on 26 patients with 30 hand fractures (19 metacarpal and 11 phalangeal) treated by closed reduction and external fixation. The fixation consisted of percutaneous and transversely applied Kirschner wires that were fixed externally with methylmethacrylate rods. Active range of motion exercises were started 1 week after reduction with the external fixator in place. Percentage return of total range of motion in phalangeal fractures varied from 66% to 98% (mean, 84%), and in metacarpal fractures it varied from 77% to 100% (mean, 96%).

Adolescent↗
PubMed1992

Treatment of hand injuries by external fixation.

Thirty-five consecutive applications of external fixation to the hand, including 27 acute cases and 8 reconstructive procedures, were studied. In both settings, external fixation was used not only for skeletal stabilization but also for management of the soft tissues. Twenty of the 22 acute fractures healed, and six arthrodeses with interposition bone grafts resulted in fusion. Three septic nonunions resolved, and two united successfully. There were no complications. We recommend external fixation systems in the hand, and several case reports are included in the study to illustrate the various applications.

Adolescent↗
PubMed1990

Design and testing of external fixator bone screws.

In external fixation, bone screw loosening still presents a major clinical problem. For this study, the design factors influencing the mechanics of the bone-screw interface were analysed and various experimental screws designed with the intention of maximizing the strength and stiffness of the inserted screw. Push-in, pull-out and bending tests were then carried out on the three experimental screws, and on two commercially available screws in both a synthetic material and in cadaveric bone; photoelastic tests on different screw threadforms were also performed. The results of the push-in and pull-out tests indicate that both the screw threadform and cutting head have a significant effect on the holding strength of the screw. The photoelastic tests show that most of the applied load is distributed over the first few threads closest to the load, and that the area between the thread crests is subjected to high shear stresses.

Biomechanical Phenomena↗
PubMed1992

[Stabilizing the pelvic ring with the external fixator. Biomechanical studies and clinical experiences].

Experimental studies were performed on anatomic pelvis specimens. In different series of experiments the positioning of the screws and the assembly of the external fixator were changed. We tried fixing the external fixator to the screws at varying distances from the body surface. For stabilisation of the fractured pelvic girdle a self-constructed "bow fixator", fixed to supra-acetabular screws with proximal compression and distal traction showed the best results. Homogeneous distribution of the pressure could be achieved on the unstable dorsal pelvic ring structures. In clinical routine we used the triangular external fixator, which in the experimental situation yielded results close to those of the bow fixator. External fixation of the pelvic girdle has been performed 128 times since 1977, in January 1991 a prospective study was started. For Tile type B injuries the external fixator itself represents an effective, minimally invasive system, but type C fractures often require an additional internal fixation of the dorsal lesion.

Acetabulum↗
PubMed1992

A report of the first 20 cases using a simple external fixator.

The results of treatment using a locally-designed external fixator in 20 patients are presented. Open fractures were the main indications for external fixation. Pin tract infection occurred in 8 patients. Only 2 patients had unstable fixation which required removal of the device. One third of patients developed malunion exceeding 15 degrees and two thirds had joint stiffness after conversion to plaster cast. This external fixator is adequate in the treatment of most open fractures of the tibia. However, improved techniques of pin insertion and cast application upon removal of the external fixator may help to reduce the incidence of pin tract infections and malunion.

Adolescent↗
PubMed1991

External fixation of distal radial fractures: results and complications.

External fixation of unstable fractures of the distal radius yields satisfactory results but has a high complication rate. We studied thirty-five fractures in thirty-four patients to determine whether the results obtained with external fixation warranted it use. At a mean follow-up period of 31 months, the results of treatment were assessed by interviews and clinical and radiographic examination of both wrists. Twelve fractures had an excellent result, twelve had a good result, ten had a fair result, and one had a poor result. Radiographic results were graded excellent in ten fractures, good in thirteen, fair in five, and poor in seven. No correlation was found between the anatomical results and the clinical results or the patients' subjective ratings. Complications that were related directly to the fixation pins occurred in fourteen of the fractures. There were forty-five additional complications. The frequency of complications and the limitations of external fixation demand caution on the part of the surgeon to prevent iatrogenic morbidity, which would limit the benefits of the technique.

Adult↗