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At least 1,045 records · Page 58Linked to original sources
PubMed2001

Knee flexion contractures: soft tissue correction with monolateral external fixation.

We assessed the efficacy of progressive soft tissue distraction using monolateral external fixation in the management of severe knee flexion contractures. We prospectively evaluated 10 knee deformities in seven pediatric patients. After gradual distraction using the modified Orthofix Limb Reconstruction System (LRS), most recent functional status and knee range of motion were determined. This treatment was applied to 10 extremities in seven patients, ranging in age from 2 to 16 years. Diagnoses included arthrogryposis (4), sickle cell disease (1), previous sepsis (1), and congenital pterygium (1). Average preoperative flexion contracture was 80.5 degrees. Each patient achieved full extension. There was one recurrence, despite bracing, which was managed with replacement of the fixator and soft tissue procedures. Management of knee flexion contractures using a monolateral fixator appears to be a viable alternative to extensive release or femoral osteotomy. Long-term follow-up will be essential to assess the overall risk of recurrence and complications.

Adolescent↗
PubMed2005

[Management of fibular hemimelia with the Ilizarov circular external fixator].

OBJECTIVES: We evaluated the results of treatment with the Ilizarov circular external fixator for limb length inequality and deformities in patients with type IA, IB, and type II fibular hemimelia. METHODS: Tibial corticotomy and distraction osteogenesis with the Ilizarov technique were performed in five male patients (mean age 11.4 years; range 4 to 20 years). According to the classification of Achterman and Kalamchi, fibular hemimelia was type IA, IB, and II in three patients, one patient, and one patient, respectively. Involvement was on the right in three patients, and on the left in two patients. Two patients had equinus and one patient had valgus deformities. No instability existed in the ankle and knee joints. The mean leg discrepancy was 8.7 cm (range 3 to 16.5 cm), and the mean lengthening index was 1.6 cm/month (range 1.4 to 2 cm). The mean follow-up was 33 months (range 15 to 68 months). RESULTS: On final examinations, full range of motion of the knee was obtained. A plantigrade foot was achieved in three feet, while two sustained an equinus deformity of 17 and 15 degrees, respectively. Pin tract infections were observed in four patients, all of which were treated with oral antibiotics and dressing. During distraction, three patients had pain. Two patients had a limited range of motion of the ankle joint, without instability or subluxation of the ankle and knee joints. These joint problems were successfully dealt with by physical exercises. CONCLUSION: The Ilizarov technique is a convenient method in the correction of angular and rotational deformities while enabling distraction in type I and type II fibular hemimelia.

Abnormalities, Multiple↗
PubMed1978

[An external fixation frame in auto-polymerising acrylic resin (author's transl)].

An external fixation frame for the leg is made up of Bonnel pins, strengthened by bands of autopolymerising resin. The experiment shows this apparatus to be solid, reliable and easy to use. The technique of application is extremely simple and the cost low. The indications are the same as those of proven classical fixation devices, which must be preferred for the moment, when possible. Its use is therefore limited, but justified under special circumstances (poorly equipped units far from major centres, war surgery).

Acrylic Resins↗
PubMedDate not supplied

[A comparative mechanical study of types of external fixator (author's transl)].

The authors have designed and original type of external fixator which can be used in the forces in case of armed conflict. Study has been directed towards a simple, strong and inexpensive apparatus which can be applied in emergency circumstances. Secondarily it can be replaced by another apparatus to allow compression, distraction or better reduction of a fracture without removal of the pins. The fixator should be applied as close as possible to bone and there should be three pins in each fragment, one close to the fracture, one distant and one intermediate. The best methods for the insertion of the pins have been tested.

Biomechanical Phenomena↗
PubMed1981

Manipulation and external fixation of metacarpal fractures.

We have developed a method of manipulation and external fixation of metacarpal fractures using Kirschner wires bonded with acrylic resin. This simple procedure requires no special instruments and it facilitates accurate reduction and stable fixation of the fracture while allowing free movement of the hand. Access to the wound is unhampered in open fractures. Thirty-six fractures were treated by this technique. All healed within five weeks, during which time free movement of the hand was encouraged. There were no complications.

Acrylic Resins↗
PubMed1980

[Controlled tension and tension adjustment of the external fixator using a dynamometer (author's transl)].

Bone fractures treated with an external fixator tend to heal more slowly than with an internal fixator, since the tension of the fixator gradually relaxes and this decrease in pressure is not counteracted in any way. A dynamometer makes possible an exact measurement of effective compressive forces and an adjustment of the tension of the fixator. A special feature of the apparatus is an elastic metal ring. The apparatus is mounted on the free ends of both tubes of the fixator for measuring and adjusting the tension. This should be done once a week. Supported fractures are put under an axial compression of 50 kp. In the case of comminuted and defect fractures, and axial compression of 5 kp should be begun after 5 weeks, and this dosage should be increased every week.

Biomechanical Phenomena↗
PubMed1991

Intra-articular fractures of the distal part of the radius treated with the small AO external fixator.

Thirty adults who had a severely comminuted intra-articular closed fracture of the distal part of the radius were treated by closed reduction and AO external fixation consisting of a converging-pin configuration with a double row of connecting bars. The patients were followed for an average of 2.6 years (range, two to four years). Twenty-seven patients had an excellent result; two, a good result; and one, a poor result, on the basis of pain, motion, strength, and radiographic appearance. Complications were rare, and there was no loss of fixation of the pins. The average grip strength was 92 per cent of normal. Motion of the wrist and rotation of the forearm averaged more than 90 per cent of that of the normal side. Carpal height was used as an indicator of distraction force produced by the fixator. There was an average increase in carpal height of four millimeters initially and 3.7 millimeters immediately before removal of the fixator, indicating near-constant distraction throughout the treatment. Radial length was well maintained, with shortening averaging less than one millimeter. The converging pins of the AO fixator prevent loosening, thereby diminishing the risks of infection, loss of reduction of the fracture, and breakage of the pins. This geometry of the pins allows the use of smaller-diameter (2.5-millimeter) pins and provides rigid fixation, even in osteoporotic bone.

Adult↗
PubMed2006

Use of external fixators for open tibial injuries in the rural third world: panacea of the poor?

AIM: To determine the cost-effectiveness of external in comparison with internal fixation of tibial fractures in rural India. METHODS: A retrospective study of 41 patients with open tibial fractures and 1 with infected non-union, treated with tubular external fixators. RESULTS: The average cost to the patient of an external fixator was approximately Rs 600 (or US $12), which compares very favourably with costs of internal fixation of similar effectiveness. CONCLUSION: In rural India, the use of locally made external fixators for primary and definitive treatment of open tibial fractures is cost effective.

Adolescent↗
PubMed2000

Use of contoured bar transhock external fixators in 17 cats.

Seventeen cats with injuries involving the distal tibia, talocrural joints, tarsus and metatarsus were treated with contoured connecting bar transhock external fixators as either primary or secondary fixation. The assemblies stabilised all the injuries successfully. Fracture union was achieved in 11 out of 12 cases. Excellent results were achieved in eight cats and the outcome was satisfactory in a further five. Those cats with injuries involving talocrural joint luxation with displacement and significant periarticular soft tissue disruption had poorer long-term results. Complications occurred in seven cases.

Animals↗
PubMed2005

Determination of ankle external fixation stiffness by expedited interactive finite element analysis.

Interactive finite element analysis holds the potential to quickly and accurately determine the mechanical stiffness of alternative external fixator frame configurations. Using as an example Ilizarov distraction of the ankle, a finite element model and graphical user interface were developed that provided rapid, construct-specific information on fixation rigidity. After input of specific construct variables, the finite element software determined the resulting tibial displacement for a given configuration in typically 15s. The formulation was employed to investigate constructs used to treat end-stage arthritis, both in a parametric series and for five specific clinical distraction cases. Parametric testing of 15 individual variables revealed that tibial half-pins were much more effective than transfixion wires in limiting axial tibial displacement. Factors most strongly contributing to stiffening the construct included placing the tibia closer to the fixator rings, and mounting the pins to the rings at the nearest circumferential location to the bone. Benchtop mechanical validation results differed inappreciably from the finite element computations.

Ankle↗
PubMed1999

Use of the "S" Quattro dynamic external fixator in the treatment of difficult hand fractures.

Thirty-seven patients were treated over a 7-year period using the "S" Quattro dynamic external fixator. There were 30 intra-articular and nine extra-articular fractures. Patients were reviewed at an average of 22.5 months. The average total range of motion for the affected digit at follow-up was 232 degrees for intra-articular and 241 degrees for extra-articular fractures. We believe that this device is a simple, reliable technique in the treatment of these difficult fractures.

Adolescent↗
PubMed2004

[Conversion of an external fixation to that with an intramedullary pin in cases of complicated diaphyseal fractures].

In this study the authors present a method of conversion of external fixations to closed intramedullary ones in the treatment of complicated diaphyseal fractures of the calf and femur. According to the conditions, the fixation is secured by a pin. The above mentioned procedure is advantageous especially in cases of patients with open fractures, in patients with polytraumas as well as in patients with a threatening or with a present compartment syndrome. Treatment of the above fractures is not always simple and represents a serious problem in everyday traumatological practice. Treatment of fractures using the above procedure has very good results with a minimum of complications. Although, nowadays, the skeletal defect can be solved and therefore the bearing capacity of the extremity be renewed, damages to the muscles are often irreparable and cause a permanent invalidity.

Adult↗
PubMed1998

External fixation in tumour pathology.

An appraisal of the clinical records of patients with malignant bone tumours enabled us to identify 61 whom we have treated by external fixation. There were 38 males and 23 females with ages ranging from 4 to 58 years, the mean being 14 years. The average period of follow-up was 6 years (1-12 years). For the purpose of our analysis the patients were divided into three groups according to whether the fixator was fitted before, during or after tumour resection.

Adolescent↗
PubMed1998

Pinless external fixation. Indications and preliminary results in tibial shaft fractures.

A major drawback of conventional fixator systems is the penetration of the fixator pins into the medullary canal. The pins create a direct link between the medullary cavity and the outer environment. The new AO pinless fixator bypasses this disadvantage by clamping its trocar points onto the outer cortex without penetrating it. Thus, exposure and consequent contamination of the medullary cavity does not occur. The clinical use of this easily manageable fixator with no drilling requirement is for tibial fractures in which the general and local conditions are poor or the infrastructure of the clinic is inadequate for primary internal stabilization or both. All options for a later conversion to internal fixation remain open. For highly unstable tibial shaft fractures, the pinless fixator can be applied as an additional, minimally invasive, external, locked system to increase the stability of intramedullary nail fixation. The pinless external fixator can be combined favorably with the standard AO tubular system and is a valuable addition to the existing fixator systems.

Adolescent↗
PubMed1998

Use of a hybrid external fixator for a severely comminuted juxta-articular fracture of the distal humerus.

Severely comminuted, juxta-articular fractures present a difficult management dilemma for orthopaedic surgeons. Recently, hybrid external fixators have been used for treatment of such fractures in the lower extremity, particularly in the tibial plateau and the tibial plafond. The same technique may be applied to the upper extremity with gratifying results. This technique has the advantage of minimal dissection while restoring limb alignment and permitting immediate joint motion. The proximity of neurovascular structures to the humerus requires careful attention to anatomic detail when placing such a fixator.

Adolescent↗
PubMed1990

Comparison of the Hoffmann-Vidal external fixator and the Ilizarov apparatus in the treatment of open fractures of the tibia.

In order to compare the effectiveness of the Hoffmann-Vidal external fixator and the Ilizarov compression extension apparatus, the authors compared two homogeneous groups of 25 patients, selected by the computer, with open fractures of the mid third of the tibia. Clinical and radiographic comparison provided the important data necessary for an evaluation of the reliability of the two methods.

Adult↗
PubMed2005

External fixation of closed metacarpal and phalangeal fractures of digits. A prospective study of one hundred consecutive patients.

Stable and undisplaced phalangeal and metacarpal fractures treated with strapping or functional splinting and controlled active exercises offer from about 70 to 80% of good results. The goal of treatment of closed unstable and displaced fractures should be to achieve similar or better outcome. External fixation combines the simplicity of time-honoured fixation with K-wires and an external frame to increase rigidity. This combination was used in a prospective study of 100 consecutive patients with closed fractures of the proximal and middle phalanges and the distal three-quarters of the metacarpal bones. Good clinical results (TAM > or = 230 degrees) were obtained in 76% of isolated phalangeal fractures, in all metacarpal fractures and in 89% of multiple fractures.

Adolescent↗