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 847 records · Page 47Linked to original sources
PubMed1997

External fixation or flexible intramedullary nailing for femoral shaft fractures in children. A prospective, randomised study.

We report the outcome of 19 children aged 5.2 to 13.2 years with 20 fractures of the femoral shaft requiring surgery, who were randomly assigned to have external fixation (EF) or flexible intramedullary nailing (FIN) (10 fractures each). The duration of the operation averaged 56 minutes for the EF group with 1.4 minutes of fluoroscopy, compared with 74 minutes and 2.6 minutes, respectively, for the FIN group. The early postoperative course was similar, but the FIN [corrected] group showed much more callus formation. The time to full weight-bearing, full range of movement and return to school were all shorter in the FIN group. The FIN complications included one transitory foot drop and two cases of bursitis at an insertion site. In the EF group there was one refracture, one rotatory malunion requiring remanipulation and two pin-track infections. At an average follow-up of 14 months two patients in the EF group had mild pain, four had quadriceps wasting, one had leg-length discrepancy of over 1 cm, four had malalignment of over 5 degrees, and one had limited hip rotation. In the FIN group, one patient had mild pain and one had quadriceps wasting; there were no length discrepancies, malalignment or limitation of movement. Parents of the FIN group were more satisfied. We recommend the use of flexible intramedullary nailing for fractures of the femoral shaft which require surgery, and reserve external fixation for open or severely comminuted fractures.

Absenteeism↗
PubMed2006

Treatment of osteochondral lesions of the talus with cryopreserved talar allograft and ankle distraction with external fixation.

This article presents the results of a retrospective review of six osteochondral lesions on six patients (five men and one woman) treated with transplantation of cryopreserved talar allograft and ankle joint distraction. All patients complained of ankle pain existing for a long time secondary to a traumatic episode confirmed through MRI. Lesions ranged in measurement from 0.8 cm x 0.8 cm to 3.2 cm x 1.8 cm with an average size of 2.1 cm x 1.5 cm. Each patient underwent talar dome transplantation using fresh frozen talar allograft followed by ankle distraction. Distraction was obtained using a three-ring multiplanar external fixation device. All surgeries were performed between 2002 and 2004. All external fixators were removed at 8 weeks and patients remained partial-weight bearing in a removable cast boot for an additional 8 weeks. Serial postoperative radiographs showed complete consolidation of the allograft within 16 weeks. The average follow up time was 24 months, and all patients related a subjective decrease in symptoms and increase in activity levels. Patients were also evaluated utilizing the Maryland Foot Score both pre- and postoperatively. Preoperatively, four patients were graded as fair and two were graded as poor. Postoperatively, two patients related excellent results, three patients related good results, and one patient related fair results. Several patients experienced minor complications such as pin site irritation (five patients), painful talar wire (one patient), and periostitis (one patient). No patients experienced any major complications and none have required additional surgery. We feel that these initial results warrant further investigation of this treatment.

Adult↗
PubMed1980

How to increase the stability of external fixation units. Mechanical tests and theoretical studies.

From general physical laws simple formulae have been deduced from which the rigidity of an external fixation unit mounted in different ways becomes mathematically calculable. Furthermore, the stability of various mounting systems under bending forces was investigated experimentally. Particular attention was paid to details of operating technique which are of special importance to the stability of the whole construction. The calculated data are consistent with the mechanical test results. The best arrangement of the Steinmann pins and Schanz screws is discussed, and how to mount the frame optimally, depending on the specific type and location of the fracture. Special instructions concerning the mounting of the external fixation unit are given which, depending on the specific circumstances, guarantee optimum stability of the unit.

Biomechanical Phenomena↗
PubMed1991

Reduction of treatment-related complications in the external fixation of complex distal radius fractures.

Treatment-related complications in the external fixation of complex distal radius fractures may be diminished by the insertion of 4-mm, self-tapping half-pins after predrilling. The pins are placed proximally in the radius and distally through six cortices of the second and third metacarpals. An adaptable fixation device that allows reduction after pin insertion and assembly is recommended. It must allow enough mobility to completely reduce a very unstable fracture after its application. A limited open surgical approach allows direct visualization of the bone where the fixator pins will be placed, as well as central insertion of the pins. It avoids eccentric drill placement, open section defects, redrilling, and damage to soft-tissue structures.

Biomechanical Phenomena↗
PubMed1999

[The treatment of unstable fractures of the distal radius using a bridging external fixator. Results from a long-term evaluation].

INTRODUCTION: The aim of our study was to evaluate external fixation in the treatment of unstable distal radius fractures in a long-term follow-up. METHODS: Within 8 years 174 patients with severely displaced distal radius fractures were included in a prospective study and treated with an external wrist fixator (Orthofix Srl, Italy). A total of 148 patients were reviewed with an average follow-up time of 28 months. RESULTS: Using the functional outcome score according to Gartland and Werley, we obtained 29.3 % excellent, 42.5 % good, 10.3 % fair and 2.9 % poor results; 14.9 % of the patients were not available for follow-up. Additional procedures were carried out in 54.1 % to obtain dorsal stabilization. The list of complications included two major pin-tract infections requiring surgical intervention, one pin cut out of the second metacarpal bone, one fixator dislocation, and one patient had algodystrophy. The length of the radius and joint congruity did not significantly from the situation when the fixator has been removed at the end of the treatment. CONCLUSION: The results show the importance of anatomical reduction, and especially restoration of radial length, in order to obtain good functional outcome.

Adolescent↗
PubMed1986

Late positional correction of uniting femoral fractures using the Wagner external fixator.

The use of the Wagner leg lengthening external fixator is described in six patients with extensive segmental fractures of the femoral shaft. Good fixation of the fracture is combined with the facility for distraction and lengthening of the early reparative callus up to 10 weeks after injury. The method is recommended for those patients in whom shortening and malalignment of the fracture persist as union proceeds.

Adult↗
PubMed1982

Alternative indications for external fixation according to Wagner.

Wagner's technique of external fixation was originally developed for limb-lengthening procedures. With its one-dimensional configuration and great stability, however, it is also highly suitable for application to the upper extremity and thigh for other purposes and several alternative applications are described. The more important indications are infected defect-pseudarthroses of the femur, temporary immobilization of the knee-joint, and 'unmanageable' fractures of the distal radius.

Adolescent↗
PubMed1996

External fixation of intra-articular fracture of the distal radius in young and old adults.

Forty patients (18-89 years old, mean 58 years) with comminuted intra-articular fractures of the distal radial end (AO-type C 2 or C 3) treated with external fixation could be followed for an average of 2.3 years. After 3 weeks, the distraction was released, and after another 3 weeks, the device was removed. Complications seen were one malunion, one radial shaft fracture caused by excentric drilling of a Schanz screw, one Sudeck atrophy, and one subcutaneous pin-track infection. Radial and ulnar deviations were reduced to 52% and 71% of the untreated wrist, whereas the range of motion in the other planes reached about 80% or more of the healthy side. In all, 82.5% of the patients showed good or excellent radiological and functional results. This study demonstrates that external fixation of distal radial C 2 and 3 fractures for 6 weeks results in good recovery for young patients and elderly patients with osteoporosis.

Adult↗
PubMed2001

[External fixator for reconstruction of foot statics in neurogenic osteoarthropathies].

The localization of neurogenic osteopathy in the hindfoot often results in deformities which cannot be corrected by conservative methods. Indications for operation are recurring ulcers, deep infection, and reduced stability with progressive deformity. The aim of this study was to ascertain whether external fixation enables reestablishment of foot stability even when the osteoarthropathic processes have not entirely ceased. A bilaterally mounted Hoffman 2 fixator was used for open repositioning and restabilization on 14 patients with osteoarthropathy of the hindfoot: 12 had diabetes mellitus and 13 had florid processes. Revision with axial correction was necessary in 2 patients. One underwent amputation according to Syme and received a prosthesis. Thirteen were completely remobilized: ten were fitted with an orthosis and three with a rigid orthopedic shoe. Complicated deformities of the hindfoot from neurogenic arthropathy can be satisfactorily restabilized in the edematous and demineralizing stages by surgery and the application of external fixation.

Adult↗
PubMed1997

The design and performance of an experimental external fixator with variable axial stiffness and a compressive force transducer.

A unilateral external fixator has been designed for controlled experiments into the effects of micromovement on fracture healing. The experimental model used is based on a diaphyseal osteotomy of the right tibia of the sheep. The main bar has linear bearings, which allows free axial movement. This is then controlled by a spring whose stiffness can be varied. The resulting axial micromovement can be calculated from the measured compressive force and the known axial stiffness of the fixator. The transducer has limits of error of +13.3 N and -44.5 N. Preliminary measurements showed maximum micromovement at the fracture site of 0.48 mm during slow walking.

Animals↗
PubMed1987

Fracture repair during external fixation. Torsion tests of rabbit osteotomies.

Bone repair was studied in the rabbit tibiofibular bone after a midshaft transverse osteotomy stabilized by external fixation and heavy compression. Both subendosteal and subperiosteal callus formation with concomitant contact healing were observed within 3 weeks, and were further succeeded by subendosteal resorption and increased porosis resulting in atrophy of the cortical bone. Subjected to the torsion test, the bones exhibited restoration of strength within 3 weeks, with maximal energy absorption and elasticity at 6 weeks. The failure of the osteotomy in the torsion test, with radiographic visibility of the osteotomy, characterized the soft-tissue type of behavior of the bones. Hard-tissue like behaviour of the bones with resistance to torsion at the osteotomy site and radiographic obliteration of the osteotomy line occurred by 12 weeks, indicating complete union of the osteotomy. Our experiments demonstrate that elastic external fixation is preferable to the rigid compression plate.

Animals↗
PubMed1994

Application of the pinless external fixator in severely burned patients.

In the treatment of patients with full thickness burns of the limbs adequate positioning is known as a critical condition for a favourable outcome after debridement and skin grafting. Up to now prevention of wound compression, prevention of shear forces and daily wound inspection were facilitated by using halofixators (HF) for the skull and AO external fixation (AO-EF) systems for the limbs. For the skull the HF is still the method of choice. However, in burned limbs the AO-EF has the considerable disadvantage that the pins penetrate the medullary cavity. Pin track infections, which occur quite frequently in burn patients, may thus lead to osteitis and additional impairment of the patient's compromised immune function. For these reasons, a new pinless fixation system has been introduced and tested in a series of eight patients with burns of the lower limbs. The special pin clamp system affects only the external subperiosteal portion of the bone. Application of the clamps is very fast since no drilling is necessary. The advantages of external fixation are retained without the associated disadvantages. Clinical examples are presented and discussed.

Adolescent↗
PubMed2003

Muscle strength in children treated for displaced femoral fractures by external fixation: 31 patients compared with 31 matched controls.

In a prospective study (1993-2000), we measured the isokinetic strength of the quadriceps and hamstring muscles in 31 children aged 5-17 years, on average, 3 (1.5-5) years after treatment for a displaced femoral fracture by external fixation and early mobilization. A group of age-, sex- and weight-matched children without previous injury were used as controls. The hop-index test was used to assess the patient's confidence in the injured limb and was similar in the fractured and unfractured legs as well as in the patients and controls. We measured the peak torque output at 2 angular velocities (60 degrees/s and 180 degrees/s) in the hamstring and quadriceps muscles, using Cybex testing equipment. Torque to body weight ratios were used to compare muscle strength in patients and controls. We found no differences in muscle strength between patients and controls or in the distribution of which leg was stronger, equal or weaker in the patients or controls at any test speed. External fixation and early mobilization seem to prevent residual muscle weakness, which occurs with traction or a cast for femoral fractures in children.

Adolescent↗
PubMed1991

Unstable Colles' fractures in elderly patients. A randomised trial of external fixation for redisplacement.

We report the results of a prospective randomised controlled trial of the management of 101 Colles' fractures in patients over the age of 55 years. Within two weeks of initial reduction 43 fractures had displaced with either more than 10 degrees dorsal angulation or more than 5 mm radial shortening. These patients were randomly divided into two groups: 21 were remanipulated and held by an external fixator; in the control group of 22 patients, the redisplacement was accepted and conservative treatment was continued. Patients treated with external fixation had a good anatomical result, but their function was no better than that of the control group. We found no correlation between final anatomical and functional outcome, and concluded that the severity of the original soft-tissue injury and its complications are the major determinants of functional end result.

Aged↗
PubMed1983

External fixation by Hoffmann-Vidal-Adrey osteotaxis for severe tibial fractures. Treatment scheme and technical criticism.

In addition to the many advantages of external fixation, e.g., Hoffmann's osteotaxis technique, in the treatment of severe, open tibial fractures (grades II and III), some disadvantages result from both technical factors and the nature of the bone injury. Risk of delayed union or nonunion and secondary bone atrophy is due not only to the severity, comminution, soft tissue injury, and/or infection of the fracture site but also to the prolonged use of the external fixation equipment and the long nonweight-bearing time. In addition, a small distraction between the main fragments is often present after an otherwise successful reduction of an unstable comminuted fracture. The use of compression rods in an attempt to remove the distraction often leads to loss of the reduction result (sliding effect). The necessary compression effect between the tibial fragments in early weight-bearing is further prevented by the usual early union of the fibular fracture, which enhances the danger of delayed union or nonunion in the tibia, especially in older persons. To prevent the ossification disturbances mentioned, the authors treated 79 patients during the period from 1971 to 1978 by osteotaxis consisting of (1) a relatively short fixation time (less than or equal to 10 weeks); (2) correspondingly early graded weight-bearing in a cast; and (3) prophylactic fibulectomy in patients with the distraction phenomenon of comminuted tibial fractures. These patients have been followed up for an average of more than five years. This treatment scheme used during the early phase of treatment is often effective in producing union of tibial fractures without bone grafting. However, during later phases closed intramedullary nailing (Küntscher nail) can be used as a reliable method to treat the few severe cases that are resistant to the measures mentioned.

Adolescent↗
PubMed1986

Update on external fixators in the treatment of wrist fractures.

Fifty fractures of the distal radius in 49 patients were treated by either a Roger Anderson device or a Hoffman C-series external fixator. The radiographic and clinical results were evaluated for comparison of the use of the two fixators. The follow-up period for the entire group averaged 15.9 months. For 12 patients personally examined and 12 returning a questionnaire, the follow-up period averaged 27.7 months. The Hoffman fixator and Roger Anderson device gave predictably good results in the treatment of comminuted intra-articular fractures of the distal radius when used in the active age group. Neither was found to yield superior functional results over the other, although the Hoffman fixator had a more rigid configuration. Serious complications may result from the use of external fixators, but these can be minimized by proper technique and care.

Adolescent↗
PubMed1989

[Treatment of fractures of the distal part of the forearm using external fixation].

In the years 1986-1987 the authors operated on 14 patients with 15 fractures in the area of the distal part of the forearm. They performed external fixation in open fractures and in unstable, intra-articular and extra-articular closed fractures. They use Poldi 7 external fixation device, the clamp type of fixation with the insertion of 2 screws into the radius and 2 screws into the second metacarpal. Reduction is carried out by distraction using the principle of ligamentotaxy. The evaluation of the results in the period between' 8-22 months after the operation showed excellent clinical results in 6 patients, good results in 7 patients and a fair result in one elderly female patient where a sizable radionulnar synostosis occurred during healing. Subjective feelings evaluated ten times as excellent and four times as good. In one patient the choice of the method of treatment was incorrect; an extensive lesion of ligamentary apparatus did not allow the correct reduction of fragments by distraction it was necessary to perform open reduction and transfixation of the fragments by means of K-wires, This patient was not included into the clinical results. Other more serious complications were not found out. Proceeding from their own experience the authors present some of the advantages of the method used: 1. Easy reduction and reliable retention of fragments 2. Possibility of the control and treatment of the damaged soft tissues 3. Possibility to perform additional operations without the danger of losing the reduction achieved a) fasciotomy b) spongioplasty c) skin grafts

Adult↗