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At least 739 records · Page 41Linked to original sources
PubMed1990

Treatment of comminuted distal radial fractures with preliminary horizontal finger trap traction and a Roger-Anderson external fixation device.

Over a five-year period, 43 patients with comminuted distal radial fractures were treated with a Roger-Anderson external fixation device after the fracture was aligned in Strong's horizontal finger trap traction. Nineteen patients (21 wrists) were available for personal interview and radiographic follow-up. A 0.5-mm loss of radial height and an average loss of 2.4 degrees of palmar angulation presented. Range of motion (ROM) was excellent, stiffness was nonexistent or minimal in 81%, pain was nonexistent or minimal in 86%, and weakness of grasp was nonexistent or minimal in 81%. Complications were minimal; they included three pin tract infections, two of which required pin removal before they resolved. One patient fractured a pin that also required removal. Strong's horizontal finger trap traction and the Roger-Anderson external fixation device simplified the sometimes difficult treatment of this fracture. It seems to be most effective in young athletic individuals who have good bone stock and very comminuted fractures.

Adult↗
PubMed1987

Cracking of a coated orthopaedic external fixation connecting bar.

During the course of a routine orthopaedic surgical procedure, a stainless steel external fixation connecting bar was deliberately bent to accommodate the patient's anatomy. It was found that the bar carried a nickel electrodeposited coating that flaked off the bar surface due to the bending. It is believed that the presence of a nickel coating might cause adverse tissue responses in patients and surgeons should be aware that connecting bars for external fixators might carry such coatings.

Drug Hypersensitivity↗
PubMed1992

Correction of lower limb deformity using external fixation.

The authors report their experience in treating angular and rotational deformities of the lower limb by an original method consisting of corticotomy and gradual distraction with an external fixator on the opposite side of the limb as the deformity. The Castaman angular and Monticelli-Spinelli circular external fixators were employed (Castaman, 1983; Monticelli and Spinelli, 1983, 1986, 1987).

Adolescent↗
PubMed1983

Skeletal stabilization with a multiplane external fixation device. Biomechanical evaluation and finite element model.

The general question of the influence of fracture stability on bone healing remains unanswered and has important bearing on fracture stabilization by external fixation. The stiffness of an external fixator is dependent on pin placement and frame orientation. These parameters are under the surgeon's control, within limits set by soft tissue injury and fixator design. Fixator configuration parameters include common fragment pin separation, common fragment pin angle, common fragment pin number, effective pin length, use of transfixing pins versus half-pins, and use of two versus three connecting rods. Each configuration parameter was varied independently under compressive, bending, and torsional load to determine the influence of that parameter on fracture stability under such loads. The interaction between these configuration parameters is complex. In general terms, fracture site stability may be increased by increasing common fragment pin separation, placing common fragment pins orthogonal to one another, increasing common fragment pin number, decreasing effective pin length, using transfixing rather than half-pins, and using as many connecting rods as possible. The difference between fracture site stability attainable with transfixing pins and with half-pins may be minimal if implementation of the other parameters combined with half-pins is optimized.

Biomechanical Phenomena↗
PubMed1997

[External fixation in the foot and distal portion of the leg].

The author focused attention on the possibility of external fixation of the foot and distal leg. He uses an external device-MIDI. The use of this type of fixation device is suitable in all types of fractures and dislocations in the region of the foot and distal leg and reduces the period of treatment with variable use of free movement in the ankle joint or free movement of the toes after application of the external fixation device.

Adult↗
PubMed1999

The evaluation of tension in an experimental model of external fixation of distal radius fractures.

A cadavaric model was used to evaluate the previously reported methods of determining excessive tension when applying an external fixator across the wrist. An osteotomy of the distal radius was performed and tension was applied incrementally across the joint in 9 cadaveric specimens. The fingers of each specimen could fully flex to the palm at all levels of tension tested. Although the radiocarpal and midcarpal joint spaces did lengthen with incremental changes in the amount of tension, there was no statistically significant correlation that could be made about the difference between the radiocarpal and midcarpal spaces and tension applied across the wrist. Although the carpal height ratio increased significantly from 0 to 10 lb of traction, the carpal height ratio appeared to plateau after further increases in tension. In conclusion, surgeons need to be careful when using any of these previously reported techniques for determining the optimal tension to be applied with an external fixator across the wrist. These techniques may not reproducibly allow the surgeon to detect whether there is excessive distraction across the distal radius fracture.

External Fixators↗
PubMed1980

External fixation in pelvic fractures.

The treatment of unstable pelvic ring fractures, markedly comminuted and displaced acetabular fractures, and combinations of these insults to the pelvis has been an unsolved problem in orthopedics up to the present time. Of the previous methods of treatment, external fixation has appeared to hold the most promise for certain major pelvic insults, especially those accompanied by instability of the pelvic ring. Many of the previously used external fixation devices, however, have not provided adequate stability. Recently we have modified the Hoffmann external frame to provide a simple method of treatment for unstable pelvic ring fractures that permits the patient to undergo immediate mobilization from bed to chair. Certain other complex central acetabular fractures and combined insults involving the pelvic ring, central acetabulum, and proximal femur have been treated by extensive external frames. The results of these methods are described. Although such external devices appear to be superior to previously available methods, nevertheless, in view of their inherent limitations, we have begun to explore possible methods of internal fixation of the posterior portion of the disrupted pelvic ring combined with internal or external fixation of the anterior segment of the pelvis.

Adolescent↗
PubMedDate not supplied

Hip arthrodesis in adolescents using external fixation.

Between 1994 and 1998, seven adolescents underwent hip arthrodesis with the use of an external fixator. Mean time of follow-up was 24.0 months after surgery. The duration of fixation and time to fusion were 6.6 months (range, 5-9.5 months) and 8.0 months (range, 5.2-15 months), respectively. At most recent follow-up, there was a significant improvement in the mean modified Harris hip score, in which the maximum score is 91 points after omitting 9 points for hip range of motion and deformity, from 25.7 before surgery to 66.7 after surgery (p < 0.01). The advantages of this procedure include (i) the ease and accuracy of obtaining the proper position for fusion, (ii) the ability to lengthen the affected leg at the same time, (iii) the diminished likelihood of compromising future hip operations, and (iv) the ability to ambulate and bear weight throughout the treatment course. We recommend this method of hip arthrodesis with external fixation for patients with intractable hip pain necessitating this procedure.

Adolescent↗
PubMed2001

Management of non-unions with mono-lateral external fixation.

UNLABELLED: We reviewed a cohort of 107 patients (110 long bone segments) with fracture non-union, treated by mono-lateral external fixation in Sheffield between 1987 and 1996. There were 83 males and 24 females with a mean age of 36 years. Sixty-seven patients had high-energy injuries and there were 56 open fractures. There were 60 tibiae, 38 femora and the rest were upper limb long bones with a mean of 3.2 previous procedures. The mean duration of non-union was 23.4 months (range 3-123). There were 61 mono-focal procedures with 41 supported in neutralisation, 20 in compression and three in distraction. There were 49 bifocal procedures (33 compression distraction and 16 bone transport). Seventy-one segments required a bone graft. The success rate using the initial fixator was 90%. Seven patients required further fixation to achieve clinical and radiological union, bringing the healing rate to 95.5% (total n=105). There were five amputations, all in smokers and three of them were directly related to vascular failure. The mean hospital stay was 21 days and the mean number of operations per patients was 2.55. The mean time to bony union was 12.69 months (range 2.5-64). The mean length gain was 4.5 cm (range 1.5-12 cm), the mean angular correction achieved was 12 degree (range 2-39 degree). The bony and functional results were assessed at the end of treatment by system described by Paley and Catagni (JBJS 77A, 1995). CONCLUSIONS: Mono-lateral external fixation can provide stable fixation for the treatment of established non-unions. The fracture environment may be carefully controlled and angulation and length corrected simultaneously. Interestingly 11 out of 12 problem cases were in smokers.

Adolescent↗
PubMed1990

[Lengthening and correction of deformation of the femur in children and adolescents using rod and bar-rod apparatus of external fixation].

55 patients with thigh shortening and deformations have been subjected to 65 operations with the use of the rod-based apparatus with outer fixation. Original arrangement diagrams and indications for application of apparatus with external fixation of different versions are provided. Planned lengthening has been achieved with 54 patients. Decrease of the apparatus mass and dimensions, reduction of operative intervention time period, improvement of conditions of remedial gymnastics carrying out and patient self-servicing are considered as advantages of the rod-based apparatus with external fixation.

Adolescent↗
PubMed1990

[Extension or osteosynthesis of juvenile femoral shaft fractures--experiences with the external fixator].

Since 1988 14 femoral shaft fractures were primarily treated in children using the AO-external fixation technique. In contrast to the patients treated by extension only, early mobilisation and out-patient management of these patients became possible. However the time of consolidation was prolonged, probably due to the rigidity of the unilateral double tube AO-external fixator and consequently the insufficient dynamisation of the fracture. Despite of technical complications having occurred in two patients we will continue to apply this method of treatment for femoral shaft fractures. This because the above-mentioned fundamental advantages of this osteosynthesis. For future use a new system with improved means of dynamisation is in evaluation.

Adolescent↗
PubMed1998

External fixation of lower limb fractures in children.

26 children with 29 lower limb fractures, between the age of 2 and 15 years, were treated with an external fixator. The average time to union and removal of the fixator was 71 days for femoral and 73 days for tibial fractures. Complications included pin problems in nine cases, two devices had to be replaced with a cast and one refracture. Leg length discrepancies were noted in five children and radiological malalignment in three. We recommend external fixation for all femoral shaft fractures and all open or dislocated tibial and tibia and fibula fractures beginning at the age of three to adolescence.

Child↗
PubMed1998

Redisplaced unstable fractures of the distal radius. A randomised, prospective study of bridging versus non-bridging external fixation.

A randomised, prospective study was carried out on 60 patients with unstable fractures of the distal radius to compare bridging with non-bridging external fixation using pins placed in the distal fragment of the radius. The radiological results showed significant improvement in the non-bridging group at all stages of review. In particular, normal volar tilt and carpal alignment were regained and maintained. The functional results at six weeks, three months, six months and one year showed statistically better grip strength and flexion in the non-bridging group at all stages of review. Other ranges of movement showed an early advantage in the non-bridging group. Non-bridging external fixation is the treatment of choice for unstable fractures of the distal radius which have sufficient space for the placement of pins in the distal fragment.

Adult↗
PubMed1979

External fixation of unstable pelvic fractures.

The Hoffmann external fixator was used to stabilize unstable pelvic fractures in 56 patients with multiple injuries. It was applied under general anaesthesia and the dislocated pelvis reduced and secured with a single tie bar. In 16 cases residual dislocation of less than 1.5 cm was noted after the reduction and the reduced position was maintained in 48 out of 51 cases, a minor redislocation occurred in the remaining 3 patients. Few complications could be attributed to the method, infection was noted in one patient, the iliac crest was fractured in one case and an exostosis of the iliac crest occurred in one youth. Forty-three patients were symptom free with regard to the pelvis at the time of review whereas 5 patients had residual pain and 3 diffuse symptoms. The technique of application is simple but requires two surgeons at the time of reduction and fixation of the pelvis.

Adolescent↗
PubMed1982

Results of treatment using the Hoffmann external fixator for fractures of the tibial diaphysis.

External fixation via the Hoffmann apparatus was employed as primary treatment in 19 patients and as secondary treatment in eight patients. These were severe fractures: almost all were open, comminution was present in 66%, 50% were classified as Grade III, and 50% had other orthopedic injuries. The majority of patients had delayed unions. Overall, three nonunions (13%) resulted, yet the malunion rate was 39%. Forty-five per cent of patients required a bone graft for eventual union. Fifty per cent had drainage from their pin tracts yet only two required debridement and all eventually resolved. Almost one half of the patients had neurologic impairment, primarily because of severe compartment syndromes (all in open fractures, all treated with fasciotomies) and four major vascular injuries. The most common neurologic sequela was footdrop, found in eight patients. The Hoffmann fixator is valuable, but only in severe injuries, as complications do occur which might be avoided with simpler methods of treatment.

Fracture Fixation↗
PubMed1989

[Use of equipment for external fixation and rehabilitation of patients with hemophilia].

External fixation apparatus (EFA), hing-distraction and compression-distraction, were used in 30 hemophiliacs for the treatment of hemophilic arthrosis, intra-articular and extra-articular fractures, contractures, dislocations, as well as after synovectomy. The treatment was conducted under cryoprecipitate protection, the dose of which was significantly decreased after granulation around the pins was completed. Immediate and late results of the treatment showed its higher effectiveness as compared to other correction methods (gypsum etc). After correction with EFA repeated hemorrhage and trauma were less frequent, and mean annual cryoprecipitate expense decreased five-fold. No severe complications were recorded. EFA enable successful treatment of such diseases of the locomotor system that are unaffected by other therapeutic measures.

Adolescent↗