Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “External Fixators”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 541 records · Page 30Linked to original sources
PubMed2002

[External fixation of fractures using Dysnastab-S stabilizers for massive ankle fractures of tibial bone epiphyseal articulations ].

Massive ankle fractures lead to joint stiffness and resulting decrease in range of motion. This can be avoided by functional treatment. In cases where severe soft tissue trauma coexists with bone fractures surgical treatment is limited and external fixation is the method of choice. Modern external fixation technique allows for stabilisation and maintaining range of motion in the affected joint. This paper presents the results of application of the Dynastab-S external fixator. The construction of this fixator allows dorsal and plantar, reducing postraumatic joint stiffness. It also allows appropriate insight into soft tissues and debridement of devitalised tissues as well as their forthcoming surgical reconstruction. In our material (27 cases) treated with the Dynastab-S fixator for an average of 16 weeks a satisfactory bone healing process in all cases was noted. Appropriate function of the extremity was maintained, with comparable plantar flexion to the contralateral, not affected joint. Only in one case post operative treatment was complicated by algodystrophy. Our observations showed that implementation of modern external stabilisation techniques leads to appropriate fracture healing with full function of the inferior extremity.

Adult↗
PubMed2007

Two-ring hybrid external fixation of distal tibial fractures: a review of 47 cases.

BACKGROUND: The healing of a metaphyseal fracture line is a major problem in cases of distal tibial fracture treated with external fixation. METHODS: Forty-seven distal tibial fractures treated with two-ring Ilizarov hybrid external fixation (16 AO/OTA type A and 31 type C, 10 open) were followed up. Fracture reduction and union time was evaluated and IOWA and RAND 36-Item Health Survey scores were used to assess functional outcome. RESULTS: Thirty-five fractures united uneventfully in a median time of 20 weeks, but 12 fractures needed additional procedures because of delayed union. According to univariate analysis, the risk factors for a longer time needed for fracture union were translational displacement and current smoking, and the risk factors for reoperation because of delayed union translational displacement fibular fracture fixation, and the number of cigarettes smoked per day. In multivariate analysis, translational displacement was a risk factor for both longer time to fracture union and reoperation and fibular fracture fixation was a risk factor for reoperation. If the translational displacement was less than 3 mm, the reoperation rate was 6%, whereas if the displacement was more than 3 mm, it was 83%. Reoperation was performed on 50% of the patients who underwent fibular fixation and on 15% of the patients who did not undergo fibular fixation. There were only marginal decreases in the range of motion and arthritis scores in the AO/OTA fracture types other than type C3. There were no significant differences in RAND 36 scores between the general Finnish population aged 18 to 64 years and our patients. CONCLUSIONS: Hybrid external fixation of distal tibial fractures is associated with delayed union, which is closely related to the degree of residual translational displacement after reduction. Fixation of an associated fibular fracture does not help to achieve better contact in the tibial fracture and increases the risk of delayed union.

Adolescent↗
PubMed2005

Nonbridging external fixation of intra-articular distal radius fractures.

New solutions to difficult problems are always welcome, but nonbridging external fixation of intra-articular fractures is still in its infancy. Multicenter clinical trials are necessary to deter-mine whether the superior results obtained with nonbridging fixation of extra-articular fractures can be duplicated. With further study and new fixator designs, it is anticipated that nonbridging external fixation of intra-articular distal radius fractures will become another viable treatment option.

Biomechanical Phenomena↗
PubMed2001

A new articulated elbow external fixation technique for difficult elbow trauma.

Articulated external fixation of the elbow allows aggressive elbow range of motion while protecting the joint and periarticular structures from excessive forces. A technique for aligning a monolateral-hinged fixator to the rotational axis of the elbow without the use of an invasive axis pin has been developed. Thirteen patients with acute and chronic post-traumatic elbow problems were treated over a four year period with this technique. An average arc of motion of 84 degrees was achieved in the frame. Frames were removed at an average of 7.6 weeks. Complications were confined to pin tract infections. In 11 patients followed for an average of 35 weeks the average arc of motion was 81 degrees. Further experience is required to determine the role of this device and to identify which elbows achieve the most benefit compared to conventional techniques.

Adult↗
PubMed2002

[Theory and software of the hexapod external fixator].

Using hexapod kinematics (Stewart platform), an external fixator was developed that can be adjusted in all six spatial degrees of freedom by means of six linear adjusting elements. With such a system, any desired three-dimensional bone movements, for example, fracture reduction or deformity correction, can be effected exactly, without having temporarily to compromise any stability already achieved or to rearrange the construction during treatment. Since the introduction of the hexapod principle by Stewart in 1965, computerized control has been deemed necessary for its application. This paper describes the mathematical basis and the software developed for clinical use. Mathematical procedures are needed for the calculation of the inverse and forward kinematics of the hexapod, and for the description of three-dimensional movements.

Biomechanical Phenomena↗
PubMed1996

Hybrid external fixation of comminuted tibial plateau fractures.

Comminuted tibial plateau fractures present a surgical challenge to the orthopaedic surgeon. Over the years, treatment has ranged from traction to cast immobilization to open reduction and internal fixation. More recently, indirect reduction techniques with external fixation have been used. At the authors' institution, from 1990 to 1992, 18 Schatzker Types V and VI tibial plateau fractures were treated in 18 patients with indirect reduction and application of a Monticelli-Spinelli hybrid external fixation system. Two patients had additional internal fixation and were excluded from this review. All 16 patients were available for followup evaluation. The mean time to union was 4.5 months. There were no nonunions. Three patients developed a varus deformity. Fifteen had radiographic evidence of early degenerative changes at 1 year followup. There were 11 superficial pin tract infections in 4 patients; all resolved with local pin care and a short course of oral antibiotics. There were no deep infections. With the added advantages of minimal to no soft tissue stripping and early knee range of motion, this technique is recommended for treatment of these difficult fractures.

Adult↗
PubMedDate not supplied

Hip arthrodesis using the AO modular external fixator.

Arthrodesis remains the treatment of choice for children and young adults with deteriorated, painful hip joints. In 1992, Fernandez Dell'Oca et al. reported on the use of the AO external fixator in hip arthrodesis. Three patients who underwent this procedure are reported. Hip arthrodesis with AO modular external fixator has all the benefits of the Thompson arthrodesis, with the added advantages of producing a solid fusion in the correct position and allowing the patient to remain ambulatory while using the external fixator.

Adolescent↗
PubMedDate not supplied

Treatment of late-onset tibia vara using afghan percutaneous osteotomy and orthofix external fixation.

The Afghan osteotomy was combined with external fixation on 19 patients (23 extremities) with late-onset tibia vara. The average weight was 258 lb and all patients weighed >95th percentile. The average preoperative deformity was 28.2 degrees. The average intraoperative correction was 27.6 degrees. Average healing time was 141 days. The mean follow-up was 2.7 years. Based on radiographic correction, at long-term follow-up, there were 15 excellent, two fair, and six poor results. The quality of the initial correction was the only significant variable, and it was borderline (p = 0.0587). Complications included loss of alignment, peroneal nerve palsy, superficial pin tract infection, deep infection, and fracture. This method offers a technically simple procedure with a relatively low complication rate. It allows early mobilization and provides the ability to manipulate the correction postoperatively. An excellent long-term outcome is predicated on achieving an acceptable initial correction as determined by intraoperative mechanical axis radiographs.

Adolescent↗
PubMed1985

Hughes external fixator in treatment of tibial fractures.

The results of a prospective trial of the use of the Hughes unilateral external fixator in the management of 48 tibial diaphyseal fractures are presented. Good results were obtained in grade II and III fractures but not in closed and grade I fractures. The results and complication rates were comparable with those of other more complex external fixators. Good results were found to be dependent on the adequacy of the initial reduction and the duration of external fixation, but independent of alterations in pin angle, length and location as well as fixator location.

Adolescent↗
PubMed1992

Revision of ankle arthrodesis with external fixation for non-union.

We evaluated the cases of twenty-six patients (twenty-six ankles) who had had revision of an ankle arthrodesis with external fixation for a nonunion, to determine the reasons for the failure of the previous arthrodesis. Eighteen patients had had supplemental bone-grafting in addition to the external fixation. The failure of the previous arthrodesis was related to inadequate fixation technique in seven patients and to technical problems in two patients; in the other seventeen patients at least one risk factor was identified. We also determined the functional results of the revision operation with external fixation for all patients. The average duration of follow-up was five years (range, two to ten years) in the twenty-two patients who did not have a reoperation for a persistent nonunion. The results were excellent in eleven patients, good in five, fair in four, and poor in six. The over-all rate of union was twenty (77 per cent) of twenty-six, comparable with that after primary arthrodesis; however, supplemental bone-grafting is usually necessary. In the current series, rigid fixation, precise apposition of bone and alignment of the foot, and early treatment of perioperative infection gave satisfactory results.

Adult↗
PubMed1988

The role of external fixation in the treatment of posttraumatic osteomyelitis.

External skeletal fixation played a central role in the reconstruction of 30 limbs involved in posttraumatic osteomyelitis. The tibia was involved in 15, the femur in six, the ankle in five, and the foot and radius in two each. Of the thirty limbs, 27 were ununited. Positive bacteriology and/or histology was found in each case. A total of 36 frames were used with 20 unilateral half-frame constructs and 16 bilateral transfixion frames. The average duration of external fixation was 60 days. Specific procedures for soft tissue coverage were required in 21 cases and autogenous bone grafting in 26. Loosening and local infection occurred in three of 168 external fixation pins. There were no cases of pin-track osteomyelitis, fractures through pintracks, or neurovascular damage from pin insertion. Infection was controlled in 29 of 30 limbs, with one requiring a below-knee amputation. Skeletal union was achieved in all cases. At an average follow-up of 35 months, 20 of 28 lower limbs in 27 patients tolerated full weight bearing without ambulatory aides. Four used a patellar tendon-bearing polypropylene orthosis, two used a cane, and one a walker. In the 23 patients ambulating without upper-extremity aides, the average time from the start of treatment to reach this functional status was 14 months.

Adult↗
PubMed1995

[Treatment by external fixator of open Gustilo stage III A and III B leg fractures].

From June 1992 to July 1993, we treated 10 consecutive open tibial fractures (6 III A and 4 III B according to the classification of Gustilo). All fractures were treated by external fixation (9 Hoffmann external fixators and 1 Orthofix). Only one patients needed a primary facsiocutaneous flap; the remaining patients were treated by skin grafting (7 cases), secondary wound (1 cases) and granulation (1 case). In 8 cases we realised a decortication and autologous bone grafting. Consolidation time was inferior or equal to 6 months in 5 patients, equal to 8 months in one and equal to 11 months in one. One patient was lost to follow-up and one ist still in treatment. In 2 patients we changed the stabilisation system and we used the Ilizarov technique, once for pseudoarthosis at 7.5 months from injury and once for bone-transfer at 3.5 months. We do not deplore any other case of pseudoarthrosis nor any case of osteitis. None of our patients needed amputation. Early and adequate soft tissue treatment is essential and decoration and bone grafting, which we used 8 times at mean of 12 weeks from injury, should be done earlier.

Adult↗
PubMed1989

Comparison of eleven external fixators for treatment of unstable wrist fractures.

We compared 11 external fixators for treatment of wrist fractures on the basis of rigidity, weight, cost, design characteristics, and provision for allowing wrist motion, and found important differences between them such as rigidity varying as much as 11 times. The Roger Anderson, Hanson Baylor Mini Hoffman, Rectangular Mini Hoffman, and Ace Colles external fixators are lightweight and have low rigidity. The C-series Hoffman unilateral frame and the A.O. have intermediate rigidity. The newly developed methylmethacrylate fixator, the regular Hoffman, the C-series Hoffman bilateral frame, and the Clyburn are more rigid. Although both the Clyburn and the Orthofix allow wrist flexion and extension, the Clyburn is lightweight and the Orthofix has the highest rigidity. These factors are analyzed and reported in a format that will guide the surgeon in the selection of an appropriate fixator for his patient with an unstable wrist fracture.

Humans↗
PubMed1991

Treatment of forearm fractures by Hoffman external fixation. A study of 93 patients.

Ninety-three patients with acute fractures of the diaphysis of one or both bones of the forearm were treated by a Hoffmann external fixator, using a half-frame configuration. Whenever possible, closed methods of reduction were used. The versatility of the Hoffmann external fixator allows multiple attempts and possible secondary resumption of the reduction. The half-frame configuration is stable enough, allowing the restoration and maintenance of the precise anatomy of the forearm bones and early active postoperative motion. The median length of retention of the external fixator was 13 weeks. Because of the elastic type of fixation, a solid periosteal callus was usually obtained. Non-union occurred in 8.5% of the patients. One refracture at the former fracture site was observed.

Adolescent↗
PubMed1998

Distraction-lengthening of digital rays using a small external fixator.

We present 19 ray lengthenings in 14 patients done with a small external fixator. In six cases the thumb was lengthened and in the other 13 cases, other digital rays. The most frequent reason for lengthening was an amputation sustained in a work accident. All the lengthenings were done by an osteotomy and subsequent gradual distraction with a small external fixator. The mean lengthening achieved was 20 mm (range, 0-32). An iliac-crest graft was needed in nine cases, corrective osteotomy in five cases and a deepening of the web in the six cases of thumb lengthening. In five cases an additional technique was needed to achieve bony consolidation. We have analysed the functional results and the ability to perform activities of daily living and resume employment. Although most of the patients had multiples injuries, the results have been very favourable, achieving a very high level of patient satisfaction.

Adolescent↗
PubMed1997

[Treatment of war injuries of the trochanter area by external fixation].

In a specific series war injuries in the trochanteric region were characterized; a limited methodological approach magnified the problem. Our experience and the treatment results (debridement, drainage and external fixation) are presented. The methodology, complications and final results are also given for 15 patients. Consolidation was achieved in primary external fixation without additional procedures such as spongioplasty or internal fixation conversion methods. The time to consolidation without complications was 28.6 weeks (24-36) and with complications (deep infections, chronic osteomyelitis) 40.8 weeks (28-68). In total, there was one poor result with angulation, shortening of the extremity and chronic intermittent fistulation. The average follow-up was 22.7 months (1-34 months). Our personal experience and the results speak on behalf of external fixation. Under war conditions, primary fixation ensures the best late anatomical and functional results. Minimal osteosynthesis improves the final outcome if the rules of application and the indications for selection are adhered to strictly.

Adolescent↗
PubMed1995

Reduction of post-traumatic osteoporosis after external fixation of tibial fractures.

Disuse osteoporosis following tibial fractures is associated with pain and prolonged rehabilitation. In a prospective study, 22 patients with stable tibial fractures treated in plaster of Paris were compared with 15 patients in whom unstable tibial fractures were treated by external fixation. All patients were allowed to bear full weight from the day after the injury. The patients treated with plaster of Paris had the less severe fractures but still had a greater number of the higher grades of osteoporosis. We found a significantly lower degree of osteoporosis in the external fixator group. A comparison of the median percentage bearing weight in the two groups of patients showed greater percentage bearing weight in the external fixator group at four and eight weeks after the injury. We suggest that the reduction of post-traumatic osteoporosis is due to improved early function and weight bearing in patients treated by external fixation.

Adolescent↗
PubMedDate not supplied

Outcomes of external fixation of pediatric femoral shaft fractures.

Thirty-seven femoral shaft fractures, in 33 patients, were treated with unilateral external fixation after reduction from 1992 through 1998. Ten girls and 23 boys ranged in age from 4 to 14 years. Thirteen children had multiple injuries, whereas 20 children had isolated fractures. Average follow-up was 3 years, 9 months, with only five children lost to follow-up. The average duration in fixator was 107 days. Thirty-six of 37 fractures healed, and there was one delayed union. There was minimal angulation, and limb-length inequality was generally <1 cm; 72.7% had pin-tract infections. Eight (21.6%) patients refractured; four occurred in the four patients with bilateral femur fractures. We agree with previous reports that external fixation remains a viable option for treatment of pediatric femoral shaft fractures. However, in our series, rate of refracture (21.6%) after removal of the external fixator is significantly higher than previously reported in literature. Children with bilateral femur fractures were at greatest risk.

Adolescent↗