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At least 19 recordsLinked to original sources
PubMed2006

A rigorous method for evaluation of the 6D compliance of external fixators.

External fixators are standard devices to stabilize bone fractures and their compliance aims at producing an interfragmentary motion that promotes rapid and successful healing. While evaluation of their axial compliance is a routine test, the quantification and interpretation of their full 6 x 6 compliance matrix is an extensive and delicate task. In this context, the objective of this study was to develop, validate and demonstrate the potential of a rigorous method to quantify their 6 x 6 compliance matrix. An experimental system was developed to apply six independent static forces and moments to an external fixator in the field of view of two infrared cameras quantifying the induced motion. The system was then tested with a calibration structure which compliance could be calculated analytically and numerically. Finally, the system was applied to compare three configurations of a commercial external wrist fixator. The results of the method proved to be reproducible and highly consistent with the linear elasticity theory in the physiological range of small deformations. A rigorous method for evaluation of the 6D compliance becomes therefore available for research in mechanobiology of fracture healing by external fixation.

Compliance↗
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↗
PubMedDate not supplied

Complex femur fractures in children: treatment with external fixation.

External fixation was used to treat complex femur fractures in 10 children. These injuries were associated with head trauma, cerebral palsy, epidermolysis bullosa, open wounds, and failed casting. The duration of external fixation averaged 8 weeks, and the mean follow-up was 5 years 8 months. At follow-up, one patient had 2.6 cm of residual shortening, and two had overgrowth. Complications included one refracture. Three children developed superficial pin site drainage. Although most femur fractures can be treated with traction or casting, external fixation may simplify overall care in children with multiple injuries and is effective in controlling unacceptable femoral shortening and angulation.

Child↗
PubMed2005

Biomechanical stability of high tibial opening wedge osteotomy: internal fixation versus external fixation.

PURPOSE: The goal of our study was to evaluate stability of internal fixation with a plate compared to external fixation in an opening wedge high tibial osteotomy model. Significance. To our knowledge, this is the only study to compare internal plate to external fixation in an opening wedge osteotomy model. The design of this cadaver study limits its direct application to clinical practice. MATERIAL AND METHOD: In each of the six pairs of fresh-frozen human cadaver knees one specimen was randomly assigned to internal plate fixation while the other was stabilized with an external fixation. The osteosynthesis plate incorporated a 12.5mm block that distracted the medial tibial cortices. Each knee was loaded on a mechanical testing machine to 700 N for 10,000 cycles to simulate immediate full weight bearing in a walking individual. SUMMARY OF RESULTS: The internal plate osteosynthesis provided significantly greater stiffness and smaller loss of correction (1.60mm) than the external fixation (3.22 mm) under cyclic loading condition (P<0.05). For static loading, the mean value of stiffness resulting in failure for the internal plate and external fixation, were respectively, 938 N/mm and 459 N/mm. Load to failure also showed two times greater stiffness in the plate osteosynthesis group. No hardware failure was observed in either construct. DISCUSSION AND CONCLUSION: Plate fixation was superior to external fixation in maintaining correction. However, progressive adjustment of the distraction with the external fixator allows precise "fine-tuning" during the healing process that is not possible with internal fixation.

Adult↗
PubMed2005

[Treatments of tibial Pilon fractures with a combination of limited internal fixation and external fixation].

OBJECTIVE: To summarize the effect and complication of treatment for Pilon fracture using limited internal fixation combined with external fixation. METHODS: From April 1996 to June 2003, 20 patients with Pilon fracture were treated with limited internal fixation combined with external fixation as the treatment group and 22 patients with Pilon fracture with other methods as the control group. The X-ray films, clinical effect and complication were analyzed and compared between 2 groups. RESULTS: All cases were followed up for 8 to 26 months (15.2 months on average). According to Helfet's criterion for clinical effect, the excellent and good rates were 75% in the treatment group and 72.7% in the control group, being no significant difference (P > 0.05). According to Burwell-charnley criterion for reduction, the X-ray film results showed the excellent and good rates were 90% in the treatment group and 86.4% in the control group, being no significant difference (P > 0.05). But there was significant difference in complications between 2 groups (P < 0.05). CONCLUSION: Limited internal fixation combined with external fixation is better in resuming ankle joint function and remarkably reducing complication, especially in reducing soft tissue complication and collapse of bone joint; it is useful in the treatment of Pilon fracture.

Adult↗
PubMed1993

Biomechanical properties and design considerations in upper extremity external fixation.

External fixation is an excellent technique for the osteosynthesis of fractures affecting the upper extremity. The rational use of the technique is based on sound principles of biology and biomechanics. Good pin design and application techniques are among the important factors for successful outcome. These factors are discussed in this article along with the advantages of external fixation.

Arm Injuries↗
PubMed2005

A randomized prospective study on the treatment of intra-articular distal radius fractures: open reduction and internal fixation with dorsal plating versus mini open reduction, percutaneous fixation, and external fixation.

PURPOSE: To compare 2 methods of surgical treatment for displaced intra-articular fractures of the distal radius: open reduction and internal fixation with dorsal plating (Pi Plate; Synthes, Paoli, PA) versus mini open reduction with percutaneous K-wire and external fixation. METHODS: Patients with AO type C intra-articular distal radius fractures were randomized into 2 groups: open reduction and internal fixation and dorsal plating or external fixation and K-wires and mini-open reduction. Patients over the age of 70 years with any associated soft-tissue or skeletal injury to the same limb and pre-existing wrist arthrosis or disability were excluded from the study. Objective, subjective, and radiographic outcomes were assessed at 2 weeks, 4 to 6 weeks, 10 to 12 weeks, 6 months, and 1- and 2-year intervals. The minimum follow-up period was 6 months; the average follow-up period was 18 months. The principal outcome analyzed was the Disabilities of the Arm, Shoulder, and Hand score. Secondary outcomes included grip strength, range of motion, surgical procedure time, complications, and radiographic parameters. The groups were equal with respect to age, gender, fracture subtype, and number of workers' compensation cases. RESULTS: No significant difference was found in the Disabilities of the Arm, Shoulder, and Hand scores, our primary outcome. The dorsal plate group, however, showed a higher complication rate when compared with the external fixator group. The plate group had significantly longer tourniquet times when compared with the external fixator group. The plate group also had higher levels of pain at 1 year when compared with the external fixator group; however, this equalized after hardware removal. The external fixator group showed an average grip strength of 97% compared with the normal side and 86% in the dorsal plate group. CONCLUSIONS: At midterm analysis the dorsal plate group showed a significantly higher complication rate compared with the external fixator group; therefore enrollment in the study was terminated. The dorsal plate group also showed statistically significant higher levels of pain, weaker grip strength, and longer surgical and tourniquet times. Based on these results we cannot recommend the use of dorsal plates in treating complex intra-articular fractures of the distal radius.

Adult↗
PubMed2006

Biomechanical analysis of fracture fixation with external fixator in vivo.

OBJECTIVE: To investigate the different ways of measuring the main axial strain during treatment with an external fixator and to find the suitable compression loaded by the external fixator at an early stage. METHODS: Eighteen healthy big-ear rabbits were randomly divided into two groups according to different measuring methods: Group A and Group B. In Group A, a strain gauge was affixed to the external tibial cortex with 502 glue, and in Group B, a bone cement-coated strain gauge was installed on the internal tibial cortex. Groups A and B were divided into two subgroups A1, A2 and B1, B2, respectively, according to the pressure of half of and the same as the body weight. A Z-shaped left mid-shaft tibial osteotomy was performed and fixed by an external fixator. RESULTS: The scaler curves of Group A changed dramatically during the early stage. The trendlines of the internal and external cortex went consistently after reaching the stable stage while the latter strain value was higher than the former. The time for Group B reaching the stable stage was short, but its absolute strain value was less than that of Group A. Before they were pressed to the stable stage, the declined speed of Subgroup A1 was more slowly than that of Subgroup A2 while the results of Subgroups B1 and B2 were same. Group A had an ascending trend after it declined while Group B didn't have. After they reached the stable stage, both Subgroups A1 and A2 had a declining trend while Subgroup A2 was more quickly than Subgroup A1, Subgroup B1 was kept at a definite level while Subgroup B2 fluctuated. CONCLUSIONS: The axial strain under external fixator can be measured by bone cement coated-strain gauge in vivo. The data may suggest that half of the body weight load was suitable for external fixator.

Animals↗
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↗
PubMedDate not supplied

Nursing the patient with an external fixator.

External fixators are an effective way of fixing broken bones while at the same time optimising patients' mobility. In this article Julie Santy describes the major issues nurses need to be aware of to contribute effectively to patient care.

Activities of Daily Living↗
PubMed1997

[Treatment of complex fractures within the hand with external fixation].

External fixation with the use of bone cement was employed in treatment for 22 metacarpal and phalangeal fractures in 18 patients. Open fractures prevailed (70%). A frame or "V" construction was used. Metal implants were connected with balls of bone cement. The average hand function loss in cases of metacarpal fractures associated with nerves and tendons lesion was 25%.

Adolescent↗
PubMed2004

[Tibial realignment with external fixator].

External fixation is a proved method for high tibial osteotomies. It is easy to access, allows postoperative corrections of the alignment, and can be removed without additional narcosis. Disadvantages are the frequent infection of the pin tracks and discomfort in bearing compared to internal fixation. In our own study no difference between unilateral and bilateral fixation could be found regarding loss of correction and complications. The advantage of unilateral fixation is the possibility of doing an open-wedge procedure by unilateral continuous callus distraction (hemicallotasis). This is indicated if medial collateral instability can be compensated by the open-wedge technique. The occurrence of neural injuries was significantly less frequent after hemicallotasis. Regular radiological and clinical control of the axis is necessary to prevent loss of correction, which was significantly more frequent in open-wedge osteotomies.

Bone Malalignment↗
PubMed1984

Bone healing after metal plate fixation and external fixation of the osteotomized rabbit tibia.

Controversy still exists as to the best method of treatment of long bone fractures. The purpose of the present study was to compare the effects on the healing bone of external fixation and metal plate fixation. In an experimental model on the rabbit tibia the stiffness of the fixation corresponded intentionally to that of the same methods in human fracture treatment. A transverse midshaft osteotomy was made on one tibia, and fixed with a steel plate (45 X 5 X 1 mm) or external mini-fixation. The animals were killed after 4, 6 or 12 weeks. The bone healing was evaluated by radiography, histology and biomechanical testing in three-point bending. There were no significant differences between plate fixation and external fixation in the pattern of bone healing, as it occurred by periosteal, intramedullary and intercortical callus after both methods. The stiffness increased more rapidly than the strength, and reached normal values after about 6 weeks. No significant differences in stiffness between the two methods were found. The strength was significantly greater after plate fixation than after external fixation at 6 weeks, while no significant differences were found at either 4 or 12 weeks. It is concluded that the speed of bone healing was more rapid after plate fixation. However, in the later stages of healing the plated bones were secondarily weakened because of the stress-protecting effect of the plate.

Animals↗
PubMed1980

A new device ("G3 - IOR") for external fixation.

External fixation is nowadays an essential part of orthopaedic and traumatological surgery, since it offers a method of firm fixation, which can be applied at some distance from the fracture. It is easy to apply and to remove and, most important, there is no direct contact with the fracture site. THe writers present an apparatus of their own design which should eliminate all the disadvantages of the apparatus at present in use, while at the same time being simpler to apply and more effective in action.

Animals↗
PubMed2002

Use of an orthopaedic fixator for external fixation of the mandible.

A patient presented with a chronically infected, non-united fracture of the mandible, with considerable bone loss. He was treated with a metacarpal fixator, the miniPennig external fixator. The fixator is stable and smaller than conventional mandibular fixators. It can be applied and removed under local anaesthesia, if necessary, requires little maintenance and produces minimal scarring. The successful outcome in this patient is encouraging and we commend the use of the fixator in similar difficult cases.

Adult↗
PubMed1986

Biocompression external fixation. Sliding external osteosynthesis.

Biocompression is a term applied to the stresses that have their origin in the elastic deformation of a diaphyseal bone, under the loads of functional activities. Its significance is the osteogenic response that biocompression stress induces in the cells of the healthy bone. The Biocompression Theory assumes that biocompression is as essential as osteogenic factors in the repair of a fracture. Thus, fracture healing requires not only stability, which is not osteogenic in itself, but physiologic biocompression. An external fixator that provides good stability and enables local biocompression has been used in the tibia of 127 patients, and healing with callus formation has been achieved in all.

Adolescent↗