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At least 55 records · Page 3Linked to original sources
PubMed1989

Treatment of unstable tibial diaphyseal fractures with minimal internal and external fixation.

We prospectively studied 20 patients whose selected unstable tibial diaphyseal fractures were treated with the combined techniques of minimal internal fixation and external fixation. Five fractures were closed and 15 were open (six Grades I and II, nine Grade III). Seventeen were due to high-energy injuries. The minimum followup was 2 years. All fractures healed, one with malalignment. Time to union averaged 12 weeks in closed fractures and 19 weeks in open fractures. All high-energy fractures underwent bone grafting. The external fixation was removed by dynamization. Thirteen complications occurred in nine patients, all with open fractures. Three of 120 pins became infected (2.5%). Early bone grafting and dynamization of the external fixation prevented the malunions and nonunions reported previously with this technique.

Adolescent↗
PubMed1994

Limited internal fixation of the tibia with external fixation: an in vivo canine study.

This study reports the results of the healing of canine tibial osteotomies with external fixation alone or in combination with a single lag screw. Twelve dogs had a midshaft tibial osteotomy performed at a 45 degree obliquity. Half of the dogs had a six-pin, unilateral, medial, external half-frame applied after the osteotomy. The remaining six had an identical frame plus a lag screw placed perpendicular to the osteotomy site. When compared with their contralateral controls, the fixator-alone group had a 16.3% (p < 0.05) decrease in bone density, whereas no significant density change was seen in the group with the additional lag screw. Torsional stiffness was 29% higher in the osteotomies treated, and tested, with the lag screw, but this did not achieve statistical significance. Computed tomography scanning revealed that the surface area was increased by an average of 30-40% in both groups, relative to contralateral controls, but there was no difference between the two treatment groups. Three tibias in the group with external fixation alone, and two tibias in the screw group showed primary bone healing without evidence of callus formation. The combination of a semirigid external fixation construct with a lag screw resulted in increased torsional stiffness but healing equal to that seen with external fixation alone.

Animals↗
PubMed1999

Fracture treatment with circular external fixation.

Circular external skeletal fixation (CEF) has been used in recent years to treat acute and chronic fractures and bone deformities, to stabilize joints while maintaining range of motion, and to perform arthrodeses and limb-sparing in dogs. Dr. Ilizarov defined the general principles and methods of CEF. This article reviews these principles. It also describes the indications, preoperative planning, surgical placement, postoperative management, clinical results, and complications of CEF used to treat fractures in dogs.

Animals↗
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↗
PubMed1996

External fixation of the wrist.

External fixation for fractures of the distal radius has been used for almost 80 years. The main objective is to gain reduction and maintain the reduction throughout the treatment period. Several fixator concepts are available and selection is based on the complexity of the case to be treated as well as the surgeon's experience. Periarticular application of the fixator with immediate use of the wrist joint is recommended whenever possible. In intra-articular fractures transarticular application is advisable. External fixation in complex fractures has to be supplemented by bone grafting, fixation wires and stabilization of the radioulnar joint. Associated injuries in distal radius fractures need to be identified and treated. The possible complications of external fixation are discussed and means to prevent them are referred to. External fixation of the distal radius has found its place as an established method in treating certain types of this common fracture.

Colles' Fracture↗
PubMed1990

A preliminary experience: the Ilizarov external fixator.

The Ilizarov external fixator, though developed over 35 years ago in the Soviet Union, is only now gaining popularity in the United States. Its design and versatility allow the physician to treat a wider range of limb maladies than other external fixation systems (eg, the Hoffmann device). The Ilizarov method of fixation also permits treatment of some orthopedic conditions that were previously considered to be untreatable, such as dwarfism. The device can be used to correct limb length discrepancies, manage open and closed fractures, nonunions, and bony or soft tissue deformities. A review of the first 25 cases performed at the University of Louisville revealed 15 which have been successfully completed with significant, but manageable complications, and 10 cases which are still in progress.

Adult↗
PubMed1998

An aiming device for pin fixation at the iliac crest for external fixation in unstable pelvic fracture.

To improve the accuracy of pinning at the iliac crest during external fixation of the pelvic fracture, an aiming device has been designed. The device consists of 3 parts: a sleeve which accommodates a 5.0 Shanz pin, a handle and guide points. The guide points were designed to grasp the iliac crest to allow proper pin fixation. The device has undergone trials to fix Shanz pins on the iliac crests of 10 cadavers by 10 recently graduated doctors. All pins were fixed in proper position and passed into the bone between the two tables of the iliac crest without penetrating the tables. The device has so far been used in 50 patients who had unstable pelvic fractures. All pins were in the proper positions and there had been no loosening at the time the pins were removed. The use of this aiming device for pinning the iliac crest for external fixation of pelvic fracture has given encouraging results.

Adult↗
PubMed1984

Healing of rabbit tibial fractures using external fixation. Effects of removal of the fixation device.

Bone healing after external fixation of rabbit tibial osteotomies was studied in order to throw light on the problem of the optimal time for removal of external fixation. The animals were divided into various groups according to different periods of time for removal of external fixation and sacrifice. The strength and stiffness of the healing bones at 12 weeks were greater in tibiae where the external fixator was removed at 4, 6 or 9 weeks than in those with the continuous presence of the fixator for 12 weeks. Although fixation is essential in the early healing period, it seems that bone healing is stimulated by the removal of the fixation after a certain period of time. The optimum time for removal of external fixation in the rabbit tibia was at 6 weeks of healing, when the bone had regained normal stiffness and about 50 per cent of normal strength. The clinical relevance of this investigation is that it might be rational to remove the external fixator before bone healing has been completed. If it is felt that healing is not secure when the fixator is removed, a tibial brace might subsequently be used for a short period.

Animals↗
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↗
PubMed1985

External fixation. Its use in podiatric surgery.

Rigid fixation of osseous fragments with the ability to supply additional compression or distraction at will is achieved only by external fixation. Of course, the treatment of nonunions, infections, fixation of osteotomies, fusion of joints, and lengthening of bone can be accomplished by other satisfactory means with and without fixation. External fixation is only one method of fixation. From this list the practitioner can choose the method of fixation best suited to the contemplated procedure and the one with which the surgeon feels most comfortable. However, a good surgeon will have prepared alternative methods of fixation if, in fact, the first and preferable method of fixation fails. It would be wonderful if our plans became a reality; quite often they do not and this is what one must prepare for. External fixation in many of the cases presented was not the original form of fixation to be used; in a few cases it had not been seriously considered. Fortunately, however, it was considered and allowed a difficult situation to be remedied with relative ease. Although elaboration of the categories in which external fixation was employed has been brief, the numerous presentations lend themselves to further investigation into external fixation.

Adult↗
PubMed1995

Open fractures of the femoral shaft, treated with osteosynthesis or temporary external fixation.

Controversy surrounds the treatment of open femoral shaft fractures, especially in the multiply injured. We report on 54 patients with 57 open femoral shaft fractures. They were treated according to our policy which deals with the severity of the soft-tissue damage. Low-grade open femoral fractures were primarily treated with internal fixation. A temporary external fixator was used for high-grade open fractures and in multiply injured patients where primary intramedullary nailing was contra-indicated. The external fixator was converted into an intramedullary nail as soon as the local soft-tissue disorders and the general condition of the patient permitted. There were no cases of deep infection. There was one case of malunion. Functional outcome was good to excellent in all cases. The aim of this paper is to show that low-grade open femoral fractures can be safely treated with primary intramedullary nailing and that temporary external fixation of severe open fractures followed by conversion into an intramedullary nail can be done without deep infection.

Adolescent↗
PubMed1986

Effects of fixation stiffness on fracture healing. External fixation of tibial osteotomy in the rabbit.

In rabbit tibial osteotomies, the effects on bone healing of three different degrees of stiffness of external fixation were investigated. Redislocation occurred in one third of the osteotomies with the least rigid fixation, and the amount of external callus was greater in this group. At 6 weeks there were no significant differences between the groups regarding bending strength and stiffness of the bones.

Animals↗
PubMed1994

[Stable joint-bridging extension of malleolar dislocations and pilon fractures with the AO pinless external fixator].

The pinless external fixator, introduced into clinical practice for open tibial fractures, suggested itself for use as a traction substitute because of its pinless frame. The aim of this feasibility study was to replace the conventional calcaneal pin traction by a joint-bridging pinless fixator, inserted under local anesthesia. 10 patients with 6 malleolar dislocation fractures, 3 pilon tibial and 1 open distal tibial fracture were immobilised by a joint-bridging pinless fixator during 10.4 days (5-16 days) till swelling had subsided and definitive fracture treatment, consisting of plate fixation, took place. The implantation of the joint-bridging pinless fixator in local anaesthesia was well tolerated by all patients. This traction substitute offered good patient comfort and easy care. Although the provided stability was less than a conventional fixator, all patients were able to lift up their fractured extremity without pain.

Aged↗
PubMed1996

Biological fixation of subtrochanteric fractures by external fixation.

Fifty-one subtrochanteric fractures have been stabilized by external fixation over the last 9 years. Union occurred in all types of fractures, usually within 6 months. Soft tissue interposition led to non-union in three patients. Refracture in one patient and significant limb-length discrepancy in two patients was seen. The technique is versatile, easily reproducible and 'biological'. Protected weight-bearing is not necessary after removal.

Adult↗
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↗
PubMed1983

External fixation. Yesterday, today, and tomorrow.

External fixation is a method of immobilization that uses percutaneous pins placed in bone and linked with external connectors. The concept of external fixation appears in works of Malgaigne from the mid-19th century. Since Malgaigne's invention many other external fixation systems have been introduced, and external fixation is currently a standard method for treating fractures.

Bone Nails↗