Anterior Pelvic Quadrangular External Fixation Frame: A Simple Modification of the Anterior External Fixator to Allow an Anterior Approach to the Pelvis

UNSTRUCTURED The retrospective study of Taylor's three-dimensional external fixator for the treatment of tibiofibular fractures provides a theoretical basis for the application of this technology. The paper collected 28 patients with tibiofibular fractures from the Department of Orthopaedics in our hospital from March 2015 to June 2018. After the treatment, the follow-up evaluation of Taylor's three-dimensional external fixator for the treatment of tibiofibular fractures and concurrency the incidence of the disease, as well as the efficacy and occurrence of the internal fixation of the treatment of tibial fractures in our hospital. The results showed that Taylor's three-dimensional external fixator was superior to orthopaedics in the treatment of tibiofibular fractures in terms of efficacy and complications. To this end, the thesis research can be concluded as follows: Taylor three-dimensional external fixation in the treatment of tibiofibular fractures is more effective, and the incidence of occurrence is low, is a new technology for the treatment of tibiofibular fractures, it is worthy of clinical promotion.

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Effect of Ring Material and Diameter on Orthopedic Implant Stability: External Fixation in Femur Bone

International Journal of Engineering & Technology ◽

10.14419/ijet.v7i4.26.22165 ◽

2018 ◽

Vol 7 (4.26) ◽

pp. 190 ◽

Cited By ~ 1

Author(s):

Nur Fatin Izzati Ibrahim ◽

Ruslizam Daud ◽

Muhammad Khairul Ali Hassan ◽

Noor Ali Hassan ◽

Noor Alia Md Zain ◽

...

Keyword(s):

External Fixation ◽

Von Mises Stress ◽

Axial Stiffness ◽

Element Analysis ◽

The Finite Element Analysis ◽

Ring Diameter ◽

The Stability ◽

Von Mises ◽

Fixation Frame ◽

Ring Material

Axial stiffness is the most important factor in stability. It is known that any changes in the diameter of any components of the frame will either increase or decrease the axial stiffness of the fixation. The model of implant and bone will be variety as the variables changes. Current studies states that ring stability are one of the most important factors in ensuring fractured bones to have a successful re-union. In circular external fixation, the stability of the pin-bone interaction is influenced by the stability of the fixation frame where the major component is the rings. The objective is to study the finite element analysis (FEA) of the external fixator assembled in human diaphysis under compression force with different materials of the exoskeleton which are stainless steel, titanium alloy, magnesium alloy and carbon fiber. The results obtained show the mechanical strength of each material where it will be used to compare the value of von-Mises stress, stiffness and total deformation to acquire the best suitable ring diameter and material. Based on the result, as the diameter of the ring increases, the stiffness of the ring will be decreased.

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Open segmental fractures of the tibia treated by external fixation

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1212732g ◽

2012 ◽

Vol 140 (11-12) ◽

pp. 732-737 ◽

Cited By ~ 1

Author(s):

Ivan Golubovic ◽

Zoran Vukasinovic ◽

Predrag Stojiljkovic ◽

Zoran Golubovic ◽

Sonja Stamenic ◽

...

Keyword(s):

External Fixation ◽

External Fixator ◽

Tibial Fractures ◽

Type I ◽

Severe Injuries ◽

Results Of Treatment ◽

Additional Surgery ◽

Segmental Fracture ◽

Segmental Fractures ◽

Angular Deformities

Introduction. Open segmental fractures of the tibia are rare but severe injuries. In these fractures the wide zone of injury (damage of all structures of the lower leg) creates very unsuitable biological conditions for healing of the fracture. Objective. The aim of our work was to present the results of treatment of patients with segmental open fractures of the tibia treated by external fixation. Methods. We analyzed treatment results of 21 patients with open segmental tibial fractures who were treated using the method of external fixation at the Clinical Center Nis from January 1, 1995 to July 31, 2010. The average age of the patients was 53 years; the youngest patient was 27 years and the oldest one 80 years. According to the Gustilo open fracture classification, there were 3 (14.3%) type I, 6 (28.6%) type II, 8 (38.1%) type IIIA, and 4 (19.0%) type IIIB. All the patients were treated by a unilateral type Mitkovic external fixator by Traffix Company. Results. Union was attained in 16 (76.2%) fractures without severe complications (pseudoarthrosis, chronic osteitis and angular deformities of over 10 degrees). Among severe complications associated with open segmental tibial fractures, in two cases we registered septic pseudoarthrosis, in one aseptic pseudoarthrosis and in two large angular deformities of the tibia after union, with a valgus of over 10 degrees and extremity shortening of over 2 cm which required additional surgery. Conclusion. External fixation by the use of Mitkovic external fixator is one of the methods of choice in the treatment of open segmental tibial fractures, which incorporated with antibiotic therapy provides good biomehanical conditions for segmental fracture healing that enables good stability of the segmental tibial fracture and decreases the risk of deep infections.

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External skeletal fixation of the tibial shaft fractures

Vojnosanitetski pregled ◽

10.2298/vsp0501011m ◽

2005 ◽

Vol 62 (1) ◽

pp. 11-15 ◽

Cited By ~ 2

Author(s):

Sasa Milenkovic ◽

Milorad Mitkovic ◽

Mile Radenkovic

Keyword(s):

External Fixation ◽

External Fixator ◽

Weight Bearing ◽

Early Mobilization ◽

Tibial Shaft ◽

Closed Fracture ◽

Early Weight Bearing ◽

Shaft Fractures ◽

Pin Tract Infection ◽

Tibial Shaft Fractures

Aim. To present the possibility of a successful use of external skeletal fixation in treating the open and closed tibial shaft fractures with Mitkovic?s external fixator. Methods. External fixation was used in 115 patients with 118 fresh tibial shaft fractures, 82 males (71.3%) and 33 females (28.7%), average age 43.92 years (16?84). Open tibial shaft fractures were present in 37 (31.36%). All the fractures were treated with Mitkovic?s external fixator type M 20. Results. The results of external fixation were excellent or good in 94.07% of the cases, and bad in 5.08%. Pin tract infection appeared in 7 (5.93%) patients. In only 3 cases an external fixator was removed and treatment continued with the functional braces. Nonunion occurred in 6 (5.08%) patients, of which 4 were with open fractures (2 Gustilo type IIIB, 1 Gustilo type IIIA, 1 Gustilo type II) and 2 with the segment fractures. Compartment syndrome was observed in 1 (0.85%) patient with closed fracture. Malunion was found in 2 (1.69%) patients. Conclusion. External fixation of tibial shaft fractures is a simple and effective method to enable the safe healing of fractures, early mobilization of the patients, early weight-bearing, as well as early rehabilitation. Fixation of tibial shaft fractures was unilateral with convergent pins orientation, and there was also a possibility of compression and distraction.

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

Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine ◽

10.1177/0954411918796533 ◽

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.

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Can a linear external fixator stand as a surgical alternative to open reduction in treating a high-grade supracondylar humerus fracture?

Journal of International Medical Research ◽

10.1177/0300060518797022 ◽

2018 ◽

Vol 47 (1) ◽

pp. 133-141

Author(s):

Barak Rinat ◽

Eytan Dujovny ◽

Noam Bor ◽

Nimrod Rozen ◽

Guy Rubin

Keyword(s):

Internal Fixation ◽

External Fixation ◽

External Fixator ◽

Closed Reduction ◽

Open Reduction ◽

High Grade ◽

Supracondylar Humerus Fractures ◽

Long Term Follow Up ◽

Humerus Fractures ◽

Carrying Angle

Objective High-grade pediatric supracondylar humerus fractures are commonly treated with closed reduction and internal fixation with percutaneous pinning. When this fails, open reduction followed by internal fixation is the widely accepted procedure of choice. Use of a lateral external fixator was recently described as an optional procedure, but evidence is scarce. Methods We investigated the outcomes of upper limbs treated by either open reduction with internal fixation or closed reduction and external fixation. Results Twenty-one patients completed the long-term follow-up; 11 underwent open reduction, and 10 underwent external fixation. Most patients in both groups reported excellent satisfaction. In both groups, the modified Disabilities of the Arm, Shoulder, and Hand score was extremely low and the average elbow range of motion was almost identical. Radiographic analysis consisting of Baumann’s angle and the carrying angle revealed no statistical difference between the two groups. Discussion Optional treatment using a linear external fixator for complex nonreducible supracondylar humerus fractures yielded acceptable clinical and radiographic results, as with open reduction. Our sample size was small, but the promising results may assist in the implementation of an alternative surgical procedure, especially in more complicated cases involving flexion-type fractures or severe soft tissue damage and swelling.

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Comparison between External Locking Plate Fixation and Conventional External Fixation for Extraarticular Proximal Tibial Fractures: A Finite Element Analysis

10.21203/rs.3.rs-955261/v1 ◽

2021 ◽

Author(s):

Dejan Blažević ◽

Janoš Kodvanj ◽

Petra Adamović ◽

Dinko Vidović ◽

Zlatko Trobonjača ◽

...

Keyword(s):

Finite Element ◽

External Fixation ◽

External Fixator ◽

Tibial Fracture ◽

Locking Plate ◽

Plate Fixation ◽

Tibial Fractures ◽

Proximal Tibial Fracture ◽

Locking Plate Fixation ◽

Maximum Stiffness

Abstract BackgroundGood clinical outcomes for locking plates as an external fixator to treat tibial fractures have been reported. However, external locking plate fixation is still generally rarely performed. This study aimed to compare the stability of external locking plate fixator with that of conventional external fixator for extraarticular proximal tibial fractures, using finite element analysis. MethodsThree models were constructed: (1) external locking plating of proximal tibial fracture with lateral proximal tibial locking plate and 5-mm screws (ELP), (2) conventional external fixation of proximal tibial fracture with an 11-mm rod and 5-mm Schanz screws (EF-11), and (3) conventional external fixation of proximal tibial fracture with a 7-mm rod and 5-mm Schanz screws (EF-7). The stress distribution, displacement at the fracture gap, and stiffness of the three finite element models at 30-, 40-, 50-, and 60-mm plate–rod offset from the lateral surface of the lateral condyle of the tibia were determined. ResultsThe conventional external fixator showed higher stiffness than did the external locking plate fixator. In all models, the stiffness decreased as the distance of the plate–rod from the bone surface increased. The maximum stiffness was 121.06 N/mm in the EF-11 model with 30-mm tibia–rod offset. In the EF-7 model group, the maximum stiffness was 40.00 N/mm in the model with 30-mm tibia–rod offset. In the ELP model group, the maximum stiffness was 35.79 N/mm in the model with 30-mm tibia–plate offsetConclusionsExternal locking plate fixation is more flexible than conventional external fixation, which can influence secondary bone healing. External locking plate fixation requires the placement of the plate as close as possible to the skin, which allow low-profile design, because the increased distance of the plate from bone can be too flexible for bone healing.

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Stability of ten configurations of the Hoffmann external-fixation frame.

The Journal of Bone and Joint Surgery (American) ◽

10.2106/00004623-198769050-00015 ◽

1987 ◽

Vol 69 (5) ◽

pp. 734-744 ◽

Cited By ~ 53

Author(s):

J B Finlay ◽

T K Moroz ◽

C H Rorabeck ◽

J R Davey ◽

R B Bourne

Keyword(s):

External Fixation ◽

Fixation Frame

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The SK™ external fixation system: description of components, instrumentation, and application techniques

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1632763 ◽

2003 ◽

Vol 16 (02) ◽

pp. 76-81 ◽

Cited By ~ 6

Author(s):

D. G. Bronson ◽

D. Ross ◽

R. D. Welch ◽

J. P. Toombs

Keyword(s):

External Fixation ◽

External Fixator ◽

Clinical Use ◽

System Description ◽

Fracture Stabilization ◽

Application Techniques ◽

Frame Construction ◽

Fixation System

SummaryThe SK™ external fixator was designed to overcome the problems commonly encountered with clinical use of the Kirschner-Ehmer (KE) splint. It enables the use of a range of different fixation pin diameters within a construct, improved pin centering within the bone, increased flexibility in frame construction and disassembly, and a decreased need for the use of full-pins to achieve fracture stabilization. The SK™ external fixator is available in three sizes: mini, small, and large. This report describes the components of the SK™ ESF system, the instrumentation needed to apply it, and the recommended application techniques.

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Surgical Treatment of an Open Elbow Dislocation with Vascular Injury: A Case Report

Acta Facultatis Medicae Naissensis ◽

10.1515/afmnai-2017-0009 ◽

2017 ◽

Vol 34 (1) ◽

pp. 77-83

Author(s):

Predrag Stojiljković ◽

Milan Jovanović ◽

Ivan Golubović ◽

Milan Mitković ◽

Marko Mladenović ◽

...

Keyword(s):

Surgical Treatment ◽

External Fixation ◽

Vascular Injury ◽

External Fixator ◽

Functional Result ◽

Wound Care ◽

Elbow Dislocation ◽

Stable Fixation ◽

Elbow Reconstruction ◽

Neurovascular Structures

SummaryOpen elbow dislocations with vascular injury are rare injuries and they most commonly occur after a fall from a high or in sports accidents. Close anatomic proximity of the joint to the neurovascular structures put them at risk of concomitant injury. The aim of this paper is to present the method of treatment of this severe injury.Herein we present a case of a female patient, 43 years old. She had suffered an open elbow dislocation with vascular injury as a result of a fall from the height of 1.5 meters. Seven hours after sustaining the injury and short preoperative preparation, reposition of the elbow, reconstruction of the vascular injury, adequate surgical treatment of the wound and external fixation of the elbow with the Mitković type external fixator were performed under general anesthesia. Four weeks after elbow stabilization with the external fixation, the external fixator was removed. The neurovascular status and final functional result of the treatment after six mounts were good.Urgent reposition, artery and vein reconstruction, and external fixation are essential in achieving good results in patients with open cubital dislocation accompanied with vascular injury. The Mitković type external fixator provides fast and stable fixation of the elbow after reposition and good conditions for wound care.

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