SEARCH · Search PubMed
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.
A cubitus varus deformity, secondary to a supracondylar fracture, was treated with a short oblique osteotomy and the Ilizarov external fixator. An excellent anatomic and functional outcome resulted. This method may prove to be of significant value in the treatment of this difficult deformity.
Nine high-energy pilon fractures with severe soft tissue injuries were treated by a medial external fixator with an articulated ankle-hinge and limited internal fixation (1.7 screws per case). A 100% union rate was achieved; however, there was a 100% complication rate associated with the fixator. Both B3 fractures required a vertical transarticular pin to maintain reduction. Seven C2 fractures suffered calcaneal screw loosening and drainage, necessitating removal of the fixator prior to union. Due to these complications, the articulated ankle hinge could not be utilized. At a minimum of 6 months follow up, eight of nine fractures had acceptable radiographic and early clinical results.
In 44 surgical high-risk patients (ASA grade 3 or 4) pertrochanteric fractures were treated with a newly developed external fixator; all fractures healed within 14 weeks. Seven patients had a superficial pin tract infection and in 12 patients the fracture united with a shortening of 18 (5-30) mm. No implant failures or limitation of knee movements were recorded. Nine patients died during the first 6 months. The "pertrochanteric fixator" is a valuable alternative for treating high-risk, elderly patients.
The fatigue performance of several types of commonly used external fixator pins was examined. The pins were tested under a cyclic bending mode. A strength reduction factor (SRF) was defined to quantify the effect of stress concentration caused by the pin threads as compared with the smooth portion of the pin. The half pins tested had much higher SRF values than the corresponding full pins because of the smaller root diameter of the threaded regions. The use of finer threads and a cold rolling process appeared to increase the pin fatigue strength. In some pins, the depth markers on the smooth portion and the self-tapping fluted region were sites of significant stress concentration. When certain half pins are severely loaded under clinical conditions, they may fracture because of fatigue.
The stability of four different types of external fixation devices was studied when they were subjected to torsion, bending and deformation under axial compression. The most stable fixation was achieved when the bone ends were in contact. The frames were weakest when the stress was applied at right angles to the plane of the frame. All four had adequate stability for fracture healing.
An external fixation device has been designed for rigid fixation of fragments of bone. It can be used in operations to lengthen the tibia and can be adapted to the compression fixation of fractures. This paper describes the apparatus and its use in the treatment of 10 complicated fractures.
This series encompasses thirteen fractures of the mandible treated by external fixation. The indications were five fractures of edentulous mandible, four fractures through missile wounding, and four fractures without soft tissue lesion treated in Africa. Twelve patients were found to show good or excellent results. In our indications, this method is a successful approach to the treatment of the fractured jaw.
A new type of external fixator bas been designed for absolute fixation and prevention of lateral migration of fragments of bone. The apparatus has been used for leg lengthening. The apparatus and the technique are described and results of the first 24 cases are presented. Complications were minimal. The technique proved to be simple to apply, and painless to the patient with his ambulation from the start. And less expense are involved because of a very short period of hospitalization.
The advantage of the herewith presented v-shaped unilateral external fixator lies in the combination of the stability characters of the v-shaped mounting with the convenience of the unilateral lay-out. The combination of the advantages of two mounting schemes that have already been clinically tested, suggest that these should be integrated into a single construction system. Both, the surgery procedure and the dynamics of the system have been described in detail. The clinical case studies document the first experience with this new mounting scheme.
The authors describe an external fixation rod apparatus and the results of its application in 28 patients with various injuries. The apparatus was used in the patients with fractures of phalanges of the fingers and metacarpal bones for extra-articular fixation after the elimination of contractures and dislocations in the joints, in cases of combined epidermatoplasty, arthrodesis, etc. The method of treatment had to be changed only in 2 patients. In all other cases the effect of the rod apparatus was positive.
A new biomechanical model using an external fixator is described, which produces physiological dynamic axial stresses on the long bones without causing harmful micromovements at the fracture site. The authors are of the opinion that their model will make it possible to stimulate fracture healing by influencing bone remodelling and tissue differentiation.
Two cases of unstable pelvic ring fractures were stabilized by external fixation with a Wagner apparatus. This enabled a pain-free mobilization treatment to be started immediately afterwards, and, already 6 weeks later, a painless mobilization with a walking frame was achieved.
We report a series of 20 children with 24 fractures that were treated using the AO tubular external fixator in a paediatric orthopaedic unit. There were no major complications related to fixator use. There were two cases of superficial pin track sepsis and one case of non-union. There were no cases of refracture after fixator removal or of leg length inequality.
40 distal radial fractures were treated using either and external fixator alone or in combination with other osteosynthetic methods. 31 fractures were available for review with an average follow up 30.3 months. They were assessed according to Pfeiffer's criteria. The functional result was very good or good in 19, moderate in 5 and poor in 7 of these fractures. The functional outcome was related to the degree of articular damage, quality of joint reconstruction and the presence of algodystrophy.
From August 91 to December 94, 20 external fixators were used for severely injured patients (avg. ISS 25.2). The fractures were essentially open book with or without lateral compression and vertical lesions. The indication for fixation was treatment of shock and stabilization in 8 cases, stabilization alone in 9 cases, and in 3 cases as complementary fixation after internal fixation of posterior lesions. The fixation of the pelvis was effective on the amount of blood loss. One acetabulum fracture required surgery, two patients had internal fixation for loss of reduction and two others for late pubic and posterior pain. The clinical results are good; they are more related to the severity of the initial lesion than to the mode of fixation or the quality of the reduction. No superficial sepsis or osteitis was observed in relation to the pins.
Two transscaphoid perilunate dislocations of the wrist, treated by trapeziolunate external fixation--1 after closed and the other after open reduction--are reported.
One hundred one cases of open tibia fractures were treated until healing with a unilateral external fixation device that permits fracture site compression with weight bearing. There were 38 type II and 63 type III (24 IIIA, 33 IIIB, six IIIC) open fractures. A standard protocol was followed including irrigation and debridement and, when necessary, flap coverage (19 cases) and bone grafting (31 cases). Fixators were applied at the first debridement and removed when the fracture was healed. All patients were permitted early partial weight bearing and progressed to full weight bearing with fixator dynamization. Ninety-six cases healed in the fixator (12-50 weeks; average, 24.6). Three of the five failures were associated with screw complications. Five patients required screw changes and 29 required oral antibiotic therapy for screw complications. Ninety-five percent of healed cases had angulation of less than 10 degrees (in any plane). There were only six fracture site infections during the course of treatment. Dynamic axial fixation may be applied at the first debridement and be used until healing in severe open tibia fractures. Change of the fixator to another treatment method is not required.
OBJECTIVES: To describe placement of hinged transarticular external fixation (HTEF) frames and evaluate their ability to protect the primary repair of unstable joints while allowing joint mobility in dogs and cats. DESIGN: Retrospective study. ANIMALS: 8 cats and 6 dogs. PROCEDURE: HTEF frames were composed of metal or epoxy connecting rods and a hinge. Measurements of range of motion of affected and contralateral joints and radiographs were made after fixator application and removal. RESULTS: 9 animals (4 cats and 5 dogs) had tarsal and 5 (4 cats and 1 dog) had stifle joint injuries. Treatment duration ranged from 45 to 100 days (median, 57 days). Ranges of motion in affected stifle and tarsal joints were 57% and 72% of control while HTEF was in place and 79% and 84% of control after frame removal. Complications were encountered in 3 cats and 2 dogs and included breakage of pins and connecting rods, hinge loosening, and failure at the hinge-epoxy interface. CONCLUSIONS AND CLINICAL RELEVANCE: HTEF in animals with traumatic joint instability provided adjunctive joint stabilization during healing and protection of the primary repair and maintained joint motion during healing, resulting in early weight bearing of the affected limb.