scholarly journals Results of application of external fixation with different types of fixators

2012 ◽  
Vol 140 (5-6) ◽  
pp. 332-338 ◽  
Author(s):  
Predrag Grubor ◽  
Milan Grubor
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Bone Fractures ◽  
Biomechanical Properties ◽  
Long Bone ◽  
External Fixators ◽  
Vertical Force ◽  
Computer Simulator ◽  
Lateral Plane ◽  
Healthy Part

Introduction. Extra-focal or external fixation is the method of fracture fixation through the healthy part of the bone using pins or wires. Objective. The aim was to determine which external splints (Ortofix, Mitkovic, Charnley and Ilizarov) had the best biomechanical properties in primary stabilization of spiral, transverse and commutative bone fractures. Methods. To determine the investigation methodology of biomechanical characteristics of the external fixator we used mathematical and computer simulator (software), juvidur physical model and clinical examination. Results. Values of advancing fragments in millimetres obtained by the study of mathematical and computer simulator (software): Charnley - 0.080 mm, Mitkovic M 20 - 0.785 mm, Ilizarov - 2.245 mm and Ortofix - 1.400 mm. In testing the juvidur model the following values were obtained: the external fixator Mitkovic M20 - 1.380 mm, Ortofix - 1.470 mm, Ilizarov - 2.410 mm, and Charnley - 2.510 mm. Clinical research of biomechanical characteristics of the effect of vertical force yielded the following results: Mitkovic M20 - 0.89 mm, Ortofix - 0.14 mm, Charnley - 0.80 mm and Ilizarov - 1.23 mm. Conclusion. When determining the total number of the stability test splints under the effect of vertical force (compression) and force effect in antero-posterior, later-lateral plane of cross, spiral and comminuted long bone fractures, the best unified biomechanical stability was shown by the following external fixators: firstly, Mitkovic M20 (0.93mm), secondly, Charnley fixator (1.14 mm), thirdly, Ortofix (1.22 mm), and fourthly, Ilizarov (1.60 mm).

scholarly journals Low cost 3D printed clamps for external fixator for developing countries: a biomechanical study

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Felix J. Landaeta ◽  
Jose Nauaki Shiozawa ◽  
Arthur Erdman ◽  
Cara Piazza
Keyword(s):  
Developing Countries ◽  
External Fixation ◽  
Axial Compression ◽  
External Fixator ◽  
Low Cost ◽  
Biomechanical Properties ◽  
External Fixators ◽  
The Novel ◽  
Astm Standard ◽  
3D Printed

Abstract Background External fixation is a mainstream limb reconstruction technique, most often used after a traumatic injury. Due to the high rates of trauma in developing countries, external fixation devices are often utilized for immediate fracture stabilization and soft tissue repair. Proper external fixation treatment too often still fails to be adopted in these regions due to the high cost and trauma complexity. A novel, inexpensive, unilateral fixator was constructed using 3D printed clamps and other readily available supporting components. ASTM standard F1541 tests were used to assess the biomechanical properties of this novel external fixator. Methods Applicable sections of ASTM standard F1541 were used to determine the biomechanical properties of the novel external fixator. 3D printed clamps modeled using SolidWorks and printed with chopped carbon fibers using a fuse deposition modeling (FDM) based 3D printer by Markforged (Boston, MA) were used. This study included 3 different testing configurations: axial compression, anterior-posterior (AP) bending, and medial-lateral (ML) bending. Using the novel unilateral fixator with 3D printed clamps previously sterilized by autoclave, an input load was applied at a rate of 20 N/s, starting at 0 N via a hydraulic MTS tester Model 359. Force and deformation data were collected at a sampling rate of 30 Hz. There was a load limit of 750 N, or until there was a maximum vertical deformation of 6 mm. Also, 4 key dimensions of the 3D printed clamps were measured pre and post autoclave: diameter, width, height and length. Results The novel external fixator had axial compression, AP and ML bending rigidities of 246.12 N/mm (σ = 8.87 N/mm), 35.98 N/mm (σ = 2.11 N/mm) and 39.60 N/mm (σ =2.60 N/mm), respectively. The 3D printed clamps shrunk unproportionally due to the autoclaving process, with the diameter, width, height and length dimensions shrinking by 2.6%, 0.2%, 1.7% and 0.3%, respectively. Conclusion Overall, the biomechanical properties of the novel fixator with 3D printed clamps assessed in this study were comparable to external fixators that are currently being used in clinical settings. While the biomechanics were comparable, the low cost and readily available components of this design meets the need for low cost external fixators in developing countries that current clinical options could not satisfy. However, further verification and validation routines to determine efficacy and safety must be conducted before this novel fixator can be clinically deployed. Also, the material composition allowed for the clamps to maintain the appropriate shape with minimal dimensional shrinkage that can be accounted for in clamp design.

scholarly journals Optimization of a Patient-Specific External Fixation Device for Lower Limb Injuries

Polymers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 2661
Author(s):  
Mohammed S. Alqahtani ◽  
Abdulsalam Abdulaziz Al-Tamimi ◽  
Mohamed H. Hassan ◽  
Fengyuan Liu ◽  
Paulo Bartolo
Keyword(s):  
Topology Optimization ◽  
External Fixation ◽  
Polylactic Acid ◽  
External Fixator ◽  
Bone Fractures ◽  
Healing Process ◽  
Patient Specific ◽  
External Fixators ◽  
Fixation Devices ◽  
Limb Injuries

The use of external fixation devices is considered a valuable approach for the treatment of bone fractures, providing proper alignment to fractured fragments and maintaining fracture stability during the healing process. The need for external fixation devices has increased due to an aging population and increased trauma incidents. The design and fabrication of external fixations are major challenges since the shape and size of the defect vary, as well as the geometry of the human limb. This requires fully personalized external fixators to improve its fit and functionality. This paper presents a methodology to design personalized lightweight external fixator devices for additive manufacturing. This methodology comprises data acquisition, Computer tomography (CT) imaging analysis and processing, Computer Aided Design (CAD) modelling and two methods (imposed predefined patterns and topology optimization) to reduce the weight of the device. Finite element analysis with full factorial design of experiments were used to determine the optimal combination of designs (topology optimization and predefined patterns), materials (polylactic acid, acrylonitrile butadiene styrene, and polyamide) and thickness (3, 4, 5 and 6 mm) to maximize the strength and stiffness of the fixator, while minimizing its weight. The optimal parameters were found to correspond to an external fixator device optimized by topology optimization, made in polylactic acid with 4 mm thickness.

scholarly journals Influence of pins configuration to balance of general transversal stability in long bone fractures external fixation

2010 ◽  
Vol 57 (4) ◽  
pp. 109-113
Author(s):  
Milan Mitkovic ◽  
Milorad Mitkovic ◽  
Marko Bumbasirevic ◽  
Marija Mitkovic
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Bone Fractures ◽  
Statistical Analyses ◽  
Axial Plane ◽  
Long Bone ◽  
Long Bones ◽  
Bone Model ◽  
Long Bone Fractures ◽  
Biomechanical Features

Biomechanical features of long bones indicate that external fixation of long bone fractures have to be balanced according to general transversal stability as more as possible. The aim of this work was to investigate the influence of orientation pins to the general transversal stability of external fixation of fractures of long bones. In this study we have used the model of fractured long bone made of wood which was treated by Mitkovic external fixator with 4 pins, in 3 different situations: 1. all pins are in one axial plane, 2. each 2 pins are in 2 axial planes with angle distances of 60o, 3. each 2 pins are in 2 axial planes wich are normal to each other. Means of relations of measured movements of long bone model fragments during the use of perpendicular force from 2 directions, normal to each other, after grouping of results in 3 groups: 0,17, 0,46 i 0,72. Statistical analyses showed that the differences between each of 3 groups were significant (p<0,05). It can be concluded that it is better if pins are oriented in different axial planes, with pretension that both planes are normal to each other, during external fixation of long bone fractures.

Methyl methacrylate in external fixation of supracondylar humerus fractures: An experimental study

2018 ◽  
Vol 232 (10) ◽  
pp. 1025-1029
Author(s):  
Ali Güleç ◽  
Mehmet Ali Acar ◽  
Bahattin Kerem Aydin ◽  
Teyfik Demir ◽  
Mustafa Özkaya
Keyword(s):  
Methyl Methacrylate ◽  
External Fixation ◽  
External Fixator ◽  
External Fixators ◽  
Three Point Bending ◽  
Fixation Methods ◽  
Supracondylar Humerus Fractures ◽  
Methacrylate Group ◽  
Humerus Fractures ◽  
K Wires

Supracondylar humerus fractures are common fractures around the elbow. Open fractures, comminuted metaphyseal fractures and also fractures with bone loss may need to be treated with external fixators. The aim of this study is to compare two different external fixators, tubular external fixators and polymethyl methacrylate with K wires external fixators, with regard to stiffness and stability for metaphyseal-diaphyseal osteotomies of distal humerus close to the joint. Six matched pairs (24 specimens) of second-generation sawbone humerus were prepared in a standard fashion to create a metaphyseal fracture, 5 cm proximal to the distal joint line of humerus and were randomly divided into two groups of 12 specimens each. Each sawbone humerus was osteotomized transversely at the mid-olecranon fossa with a 2-mm oscillating saw to simulate a Gartland type III fracture. The osteotomy was then reduced and stabilized using two different external fixation methods: carbon tubular external fixator with Schanz screws and methyl methacrylate with multiple K wires. Three-point bending and torsion tests were performed on the specimens. Bending and torsional stiffness of specimens were obtained for the fixation methods. According to the results of the study, the methyl methacrylate group has provided higher stiffness than classical tubular fixator with Schanz screws in three-point bending test (7.79 ± 2.33 N/mm vs 3.78 ± 1.18 N/mm, p = 0.006). The methyl methacrylate group also showed better stiffness in torsion test (0.12 ± 0.042 N m/° vs 0.067 ± 0.013 N m/°, p = 0.02). We determined for the first time in literature that external fixation with methyl methacrylate was significantly superior to the classical tubular external fixator with Schanz screws with regard to stiffness and stability under three-point bending and torsional loads. Moreover, methyl methacrylate is inexpensive and easily applied.

SECONDARY INTRAMEDULLARY NAILING OF OPEN LOWER EXTREMITY LONG BONE FRACTURES AFTER EXTERNAL FIXATION

1993 ◽  
Vol 86 (Supplement) ◽  
pp. 80
Author(s):  
Thomas Calton ◽  
Stephen L. Henry ◽  
Zack Stearns ◽  
David Seligson
Keyword(s):  
Lower Extremity ◽  
External Fixation ◽  
Intramedullary Nailing ◽  
Bone Fractures ◽  
Long Bone ◽  
Long Bone Fractures

Treatment of Long Bone Fractures in Calves with Ilizarov External Fixator

2018 ◽  
Vol 31 (05) ◽  
pp. 364-372
Author(s):  
Murat Sarierler ◽  
Ali Gülaydin
Keyword(s):  
External Fixator ◽  
Bone Fractures ◽  
Long Bone ◽  
Ilizarov External Fixator ◽  
Injured Limb ◽  
Radiographic Findings ◽  
Advantages And Disadvantages ◽  
The Third ◽  
Long Bone Fractures ◽  
Tract Infections

In this study, the advantages and disadvantages of Ilizarov external fixator in the treatment of long bone fractures in calves were investigated. For this purpose, 26 calves of different breeds, ages and genders, having metacarpal (n = 12), metatarsal (n = 5) and antebrachial (n = 9) fractures underwent surgery under general anaesthesia. Frames, which were prepared before surgery in accordance with the radiographic findings, were applied under open reduction in 18 cases, and under closed reduction in eight cases. In the postoperative period, all calves except one started to bear some weigh on the injured limb on the first day, while the remaining calf did the same on the second day. The consolidation started in the first 2 weeks for 24 of the calves and was completed by the day 55. In the two remaining cases, it started in the third week and was completed on day 71 and day 90, respectively.The soft tissue wounds were completely healed in all calves and no complications occurred. In five calves that were not kept in our clinic pin tract infections formed. They were controlled rapidly, and there was no change in the fracture reduction or healing duration.In conclusion, in our study, the Ilizarov external fixator system was applied to long bone fractures in cattle calves, in cases where the fragments were not large enough to apply pins and plates, and which became open and infected after defective bandage practices or unsuitable treatment. Fractures completely healed in all cases, without any complications. These results show that many of the long bone fractures experienced by calves, that were considered for amputation due to the anticipated inability to treat them successfully, could be treated with the use of the Ilizarov system.

scholarly journals A Novel Capacitive Measurement Device for Longitudinal Monitoring of Bone Fracture Healing

Sensors ◽  
2021 ◽  
Vol 21 (19) ◽  
pp. 6694
Author(s):  
Angela Sorriento ◽  
Marcello Chiurazzi ◽  
Luca Fabbri ◽  
Michelangelo Scaglione ◽  
Paolo Dario ◽  
...  
Keyword(s):  
Bone Fractures ◽  
Healing Process ◽  
Long Bone ◽  
Sensor Technology ◽  
External Fixators ◽  
X Rays ◽  
Implant Stability ◽  
Measurement Device ◽  
3D Space ◽  
Bone Callus

The healing process of surgically-stabilised long bone fractures depends on two main factors: (a) the assessment of implant stability, and (b) the knowledge of bone callus stiffness. Currently, X-rays are the main diagnostic tool used for the assessment of bone fractures. However, they are considered unsafe, and the interpretation of the clinical results is highly subjective, depending on the clinician’s experience. Hence, there is the need for objective, non-invasive and repeatable methods to allow a longitudinal assessment of implant stability and bone callus stiffness. In this work, we propose a compact and scalable system, based on capacitive sensor technology, able to measure, quantitatively, the relative pins displacements in bone fractures treated with external fixators. The measurement device proved to be easily integrable with the external fixator pins. Smart arrangements of the sensor units were exploited to discriminate relative movements of the external pins in the 3D space with a resolution of 0.5 mm and 0.5°. The proposed capacitive technology was able to detect all of the expected movements of the external pins in the 3D space, providing information on implant stability and bone callus stiffness.

scholarly journals Surgical treatment of tibial nonunion after wounding by high velocity missile and external fixators: A case report

2012 ◽  
Vol 140 (7-8) ◽  
pp. 515-520
Author(s):  
Ivan Golubovic ◽  
Zoran Vukasinovic ◽  
Predrag Stojiljkovic ◽  
Zoran Golubovic ◽  
Danilo Stojiljkovic ◽  
...  
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
High Velocity ◽  
Primary Treatment ◽  
External Fixators ◽  
Risk Of Infection ◽  
Tissue Destruction ◽  
Reconstructive Operations ◽  
Delayed Healing ◽  
Tibial Nonunion

Introduction. The missiles of modern firearms can cause severe fractures of the extremity. High velocity missile fractures of the tibia are characterized by massive tissue destruction and primary contamination with polymorphic bacteria. Treatment of these fractures is often complicated by delayed healing, poor position healing, nonhealing and bone tissue infection. Case Outline. We present the management of tibial nonunion after wounding by high velocity missile and primary treatment by external fixation in a 25-year-old patient. The patient was primarily treated with external fixation and reconstructive operations of the soft tissue without union of the fracture. Seven months after injury we placed a compression-distraction external fixator type Mitkovic and started with compression and distraction in the fracture focus after osteotomy of the fibula and autospongioplasty. We recorded satisfactory fracture healing and good functional outcome. Conclusion. Contamination and devitalization of the softtissue envelope increase the risk of infection and nonunion in fractures after wounding by high velocity missile. The use of the compression-distraction external fixator type Mitkovic may be an effective method in nonunions of the tibia after this kind of injury.

External Fixation of Long Bone Fractures in Children

1994 ◽  
Vol 29 (6) ◽  
pp. 1525
Author(s):  
Se Hyun Cho ◽  
Hae Ryong Song ◽  
Kyung Hoi Koo ◽  
Young Sik Min ◽  
Yeun Chun Jung ◽  
...  
Keyword(s):  
External Fixation ◽  
Bone Fractures ◽  
Long Bone ◽  
Long Bone Fractures ◽  
Fractures In Children
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