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 613 records · Page 34Linked to original sources
PubMed1999

Repeatability of goniometer measurements of the knee in patients wearing an Ilizarov external fixator: a clinic-based study.

OBJECTIVE: To examine the intra-tester and inter-tester reliability of three different methods of measurement of knee range of motion in patients undergoing limb reconstruction with the Ilizarov external fixator. DESIGN: Twenty-five patients had the passive range of motion of their knee measured by 13 physiotherapists who were experienced in the use of goniometry. The testers were assigned into random pairs, each tester measured three or four patients who were allocated to them using the three different methods. These were: (1) a universal goniometer aligned against anatomical landmarks, (2) a universal goniometer aligned against the Ilizarov frame and (3) a modified universal goniometer. SETTING: Orthopaedic limb reconstruction outpatient clinics. SUBJECTS: Twenty-five patients undergoing limb reconstruction using an Ilizarov external fixator on both the femur and tibia. RESULTS: Comparison of the three different goniometry methods showed that using a modified goniometer there was enhanced reliability compared with other methods. This method demonstrated good repeatability for both intra-tester and inter-tester measurements. CONCLUSIONS: When serial measurements of knee range of motion are taken in patients wearing an Ilizarov external fixator the modified model of goniometer should be used.

Adult↗
PubMed2006

Modification of the Ilizarov external fixator for aseptic hypertrophic nonunion of the clavicle: an option for treatment.

OBJECTIVE: To assess the results of treatment of aseptic hypertrophic nonunion of the clavicle by external fixation using a modified Ilizarov apparatus. DESIGN: Prospective study. SETTING: A consecutive series of 12 patients from 2 specialized orthopaedic institutions, treated by the 3 senior authors. PATIENTS: Twelve patients (5 females) with a mean age of 38.7 +/- 12.4 (range, 18-50) years with an aseptic hypertrophic nonunion of the clavicle were treated operatively during the period 1994 to 1998. Ten patients had previously been treated nonoperatively, whereas 2 had been treated surgically; the treatment in all had failed. All patients had pain with shoulder stiffness. INTERVENTION: Patients were treated using the Ilizarov external fixation technique. The operation was performed under general anesthesia and an Ilizarov external fixator was applied percutaneously under fluoroscopic control, without a skin incision or bone grafting. The patients were then monitored clinically and radiologically for 24 to 96 (mean, 45.4) months. MAIN OUTCOME MEASUREMENTS: Radiologic evaluation and clinical assessment by the Constant numerical score. RESULTS: The mean Constant preoperative score was 30.4 +/- 9 (range, 18-44). Healing of the nonunion occurred in all patients treated by the Ilizarov technique. Nine patients had pain relief and gained unlimited range of motion, whereas 3 patients had mild pain during elevation of the arm. A mean period of 75.4 (range, 50-95) days was needed for gradual bone reduction and union. The mean Constant outcome score was 68.8 +/- 14.7 (range, 46-85). COMPLICATIONS: 2 patients had superficial pin infections that cleared with local therapy and antibiotics, and 1 patient had a reoperation for a nonunion after a fall onto the floor. CONCLUSIONS: Ilizarov fixation seems to be an effective method in the treatment of aseptic hypertrophic clavicle nonunions, even in patients where previous surgery has failed.

Adolescent↗
PubMed1991

[External fixator montage].

In connection with the workshop on External Fixation of Fractures, some introductory remarks concerning indications, biomechanics, some technical details, aftercare, and possible complications are given. Each implant and technical system has advantages and disadvantages. Experiences with different implants and systems are described and demonstrated.

Biomechanical Phenomena↗
PubMed1981

The comparative stiffness of external fixation frames.

The stiffness of 6 external fixation frames was compared by measuring the deflection which occurred at an unstable fracture, created in a tibia in vitro. All tests were repeated with the frames applied to pins brazed into a steel tube, in order to eliminate any errors caused by variation in the quality of the bone under test. The results of these tests are presented and observations are made on some design features of the frames. It was found that the 2 most critical factors which determined the stiffness of a frame were the diameter and the number of pins used to transfix the bone. Other factors, such as the stiffness of the connecting bar, were of secondary importance.

Biomedical Engineering↗
PubMed1989

Treatment of displaced fractures of the proximal humerus: transcutaneous reduction and Hoffmann's external fixation.

Experience with transcutaneous reduction and external fixation of displaced fractures of the proximal humerus is presented in a series of 28 cases followed for 1 year or more. In 18 cases near-anatomical fracture reduction was obtained, while no improvement of fracture position was seen in two cases. Loosening of the pins was a major complication in five cases, all in patients with severe osteoporosis or head splitting fractures, where fracture reduction was unsatisfactory. The functional results were satisfactory, and the method is considered a useful alternative in the treatment of these difficult fractures.

Adult↗
PubMed1990

Mechanical evaluation of external fixators used in limb lengthening.

Four external fixator systems (five configurations) used for limb lengthening were tested to determine the fixator stiffness and the fracture gap rigidity. There was a statistical difference between fixators in all modes of loading with respect to stiffness, shear, and axial motion. The fixators were graded to determine their relative stiffness, shear rigidity, and axial rigidity. The EBI Orthofix proved to be the most rigid fixator relative to the configurations tested with minimal shear or axial motion at the fracture site. The Ilizarov tibial configuration was the least rigid, demonstrating more shear and axial motion at the fracture gap. The Ilizarov femoral system combined excellent stability and shear resistance with preservation of axial dynamization. Fixators with a high stiffness provide less motion at the fracture site, which may cause stress shielding of the osteotomy. Fixators that provide more motion at the fracture gap are less stable. These data may be useful in determining which fixator may be ideal for a particular clinical situation.

Biomechanical Phenomena↗
PubMed1999

Failure of reduction with an external fixator in the management of injuries of the pelvic ring. Long-term evaluation of 110 patients.

We reviewed 110 patients with an unstable fracture of the pelvic ring who had been treated with a trapezoidal external fixator after a mean follow-up of 4.1 years. There were eight open-book (type B1, B3-1) injuries, 62 lateral compression (type B2, B3-2) and 40 rotationally and vertically unstable (type C1-C3) injuries. The rate of complications was high with loss of reduction in 57%, malunion in 58%, nonunion in 5%, infection at the pin site in 24%, loosening of the pins in 2%, injury to the lateral femoral cutaneous nerve in 2%, and pressure sores in 3%. The external fixator failed to give and maintain a proper reduction in six of the eight open-book injuries, in 20 of the 62 lateral compression injuries, and in 38 of the 40 type-C injuries. Poor functional results were usually associated with failure of reduction and an unsatisfactory radiological appearance. In type-C injuries more than 10 mm of residual vertical displacement of the injury to the posterior pelvic ring was significantly related to poor outcome. In 14 patients in this unsatisfactory group poor functional results were also affected by associated nerve injuries. In lateral compression injuries the degree of displacement of fractures of the pubic rami caused by internal rotation of the hemipelvis was an important prognostic factor. External fixation may be useful in the acute phase of resuscitation but it is of limited value in the definitive treatment of an unstable type-C injury and in type-B open-book injuries. It is usually unnecessary in minimally displaced lateral compression injuries.

Activities of Daily Living↗
PubMed1987

External fixation in contemporary fracture management.

Important advances have been made within the last two decades in the field of fracture management. The development of the AO internal fixation system and the advances in cast bracing techniques are but two of the improvements worthy of mention. It is, however, in the field of external fixation of fractures that the greatest advances have been made. This paper traces the history of external fixation up to the present day and discusses, with examples, the application of external fixation in the management of complex limb fractures.

Fracture Fixation↗
PubMed1995

Investigation of the torque-tension characteristics of a flanged external fixator pin.

The torque-tension characteristics of standard, conical and flanged external fixator pins and a cortical screw were compared using a commercially available testing apparatus. The flanged pin and the screw were similar in behaviour, and converted torque into tension more efficiently than conical and standard external fixator pins.

Biomechanical Phenomena↗
PubMed2004

External fixation versus internal fixation for closed unstable intra-articular fracture of the distal radius. Early results from a prospective study.

This is a prospective study of a series of 26 patients with closed unstable comminuted intra-articular fracture distal end of the radius treated with two different methods of treatment to compare their anatomical and functional results. The external fixation group consisted of 12 patients and internal fixation group consisted of 14 patients. The anatomical and functional assessments were performed at six months and one year. The anatomical results at six months and one year showed that the internal fixation group was effective in maintaining the reduction compared to the external fixation group. The radial height, volar tilt and radial inclination were well maintained. However, the functional results at six months and one year showedno differences between these two types of fixation. The complication rate was higher in external fixation group.

Adolescent↗
PubMed2005

Non-spanning external fixation of the distal radius.

Non-spanning external fixation of the distal radius is a simple, reliable, and noninvasive technique to restore the anatomy in unstable extra-articular or minimal articular fractures of the distal radius. Rehabilitation is faster and more complete than with other comparable techniques. It is also a successful technique for stabilization of corrective osteotomy of the distal radius formal union.

Contraindications↗
PubMed1999

Unilateral tibial hemimelia with leg length inequality and varus foot: external fixator treatment.

A 15-year-old girl with type II unilateral hemimelia presented with a 13.5-cm shortening of her right leg, absence of the distal half of the tibia, tibiofibular synostosis, and medial dislocation of a cavus and varus foot. She was treated by means of an external fixator. The shortening was significantly corrected, and realignment of the foot with the limb was achieved. An arthrodesis of the talus and lower end of the fibula was carried out operatively and stabilized with an external fixator. In the same surgical procedure, we performed an osteotomy of the tibiofibular synostosis, and progressive distraction was done with another external fixator. We emphasize the advantages of progressive distraction for the correction of congenital deformities of the limbs.

Adolescent↗
PubMedDate not supplied

[Open wedge osteotomy and callus distraction by means of the external fixator in distal femur and proximal tibia in knee arthrosis with valgus and varus deformity].

Various methods can be applied for treatment of knee deformity. One of them is open wedge osteotomy and callus distraction by means of the external fixator. This paper presents the results of treatment of 16 patients with knee arthrosis associated with varus and valgus deformities (10 varus and 6 valgus deformities). Open wedge osteotomy of the varus deformity was performed in the proximal tibia, and in case of the valgus deformity in the distal part of the femur. The patients who were operated on had a knee varus larger than 10 degrees and a knee valgus larger than 12 degrees. Prior to open wedge osteotomy and application of the external fixator, knee arthroscopy was performed (meniscectomy, cartilage drilling and shaving, debridement, the extraction of loose bodies). After one-year follow-up, the final outcome of the treatment was positive in all patients. The treatment alleviated the pain in these patients. The method is minimally invasive and relatively easily applied. Mitkovic's external fixator type M20-CD-V allows for continuous callus distraction with simultaneous correction of the varus or valgus knee deformity.

Adult↗
PubMed1993

Small external fixation devices for the hand and wrist.

Small external fixators have been developed for use in the hand and wrist. The main indications are stabilization of open or infected fracture or non-union of the metacarpals and phalanges; length maintenance in segmental bone loss; and distraction-lengthening of the fingers. The device may be used also for articular or periarticular fracture, closed diaphyseal fracture in adults, fracture in children, various arthrodeses, or corrective osteotomies.

Biomechanical Phenomena↗
PubMed2005

Hydroxyapatite-coated external fixation pins.

The aim of this review is to report on studies of hydroxyapatite-coated external fixation pins as a solution to enhance pin fixation. In a highly loaded animal study, three tapered pin types were compared: Type A uncoated, Type B coated with hydroxyapatite and Type C coated with titanium. There was a 13-fold increase in the extraction torque of Type B pins compared with Type A, and a twofold increase compared with Type C pins. Extraction torque was significantly lower compared with the corresponding insertion torque in both Types A (p < 0.001) and C (p = 0.003). Conversely, with the hydroxyapatite-coated pins there was no difference between extraction and insertion torque. In a clinical study of 76 external fixation pins in 19 patients treated with hemicallotasis for osteoarthritis on the medial side of the knee, pin insertion and extraction torque forces were measured. The patients were randomized to be treated with either standard tapered pins or tapered pins coated with hydroxyapatite. Extraction torque of the hydroxyapatite-coated pins was higher than the extraction torque of the standard pins in both cancellous and cortical bone (p < 0.005). In a prospective, randomized clinical study of osteoporotic wrist fractures, extraction torque of the coated pins was higher than with standard pins (p < 0.0001). These studies demonstrate that with the use of hydroxyapatite-coated pins, no deterioration of pin fixation occurs, and that there is no significant pin loosening and infection, regardless of bone type and loading conditions.

Animals↗
PubMed1990

Applying tribological principles to improve the performance of the Hoffmann external fixator's universal joint.

As part of a continuing investigation of sources of slippage in the universal joints of external fixation devices, a study was conducted to determine if selected interfaces of the Hoffmann external fixator (rod/clip torsional, cheek/bowl and clip/cheek) could be improved by moving the point of contact between the wing-nut clamp and cheek closer to the centre of the wing-nut clamp. It was felt that the movement of the point of contact would reduce the magnitude of the frictional torque resisting the tightening of the wing-nut clamp. The point of contact was changed by the addition of a Belleville washer between the interface of the wing-nut clamp and the cheek. Increased slippage torques of approximately 100 per cent were noted in all interfaces at low values of tightening torque (6 and 8 N m) of the wing-nut clamp and improvements of not less than 50 per cent were obtained at higher tightening torques (10 and 12 N m) on the wing-nut clamp.

Biomechanical Phenomena↗
PubMed1979

Clinical results of the triangular external fixation device in serious lesions of the lower extremity.

Several types of external fixation devices exist among which those of Judet, Hoffmann, Wagner and Müller can be picked out, each of which has definite applications. Confronted with difficulty in the use and the defect of mechanical rigidity, we have been led to design a new type of the triangular external fixation device. As open fractures of the limbs in stage II and IV of Duparc and Cauchoix, and pseudoarthrosis infected need a considerable stability in addition to careful surgical treatment, so after a comparative mechanical study, and after codifying the most rigid installation, we have used it on several traffic accident victims.

Adolescent↗
PubMed2006

External fixation of femoral fractures in multiply injured intensive care unit patients.

We report the results of a prospective study of 42 patients with multiple injuries, including femoral fractures, who required intensive care unit (ICU) admission and whose fractures were treated by means of external fixation. The Injury Severity Score (ISS) ranged from 18 to 41 and the average Glasgow Coma Scale (GCS) on admission was 12. Seventeen fractures were open. All patients had their fractures stabilised within 6 hours from admission by means of external fixation. After a follow-up of 11 months (range 4-20), 28 fractures had healed within 6 months (range 4.5-8) and 13 developed non-union which was treated successfully with secondary intramedullary nailing. One patient developed deep infection following secondary nailing and another patient died from adult respiratory distress syndrome (ARDS). We conclude that external fixation of severe femoral fractures in critically ill patients is an easy and quick method of stabilisation which does not compromise their condition. If however it is intended to be used as a final method, these patients require a close follow-up since the rate of delayed and non-union is high.

Adult↗