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At least 1,063 records · Page 59Linked to original sources
PubMed2002

Chronic flexion contracture of proximal interphalangeal joint treated with the compass hinge external fixator. A consecutive series of 27 cases.

Twenty-seven chronic flexion contractures of the proximal interphalangeal joint were treated with the Compass((R)) hinge external fixator without open surgery. The fixator was removed after a mean of 33 (range, 14-68) days. The mean time from injury to operation was 4 (range, 1-19) years and all patients were reviewed at a mean follow-up of 21 (range, 12-50) months. The mean extension gain was 38 degrees (range, 0-70 degrees), and the mean flexion-extension arc improved by 42 degrees (range, 0-80 degrees). Complications included superficial pin-track infection in 11 cases and pin loosening in four cases.

Adolescent↗
PubMed1997

Superior results of tibial rodding versus external fixation in grade 3B fractures.

From 1987 to 1993, 41 Grade 3B open tibial shaft fractures were treated with the unreamed tibial nail or an external fixator. The method of treatment was left to the choice of the operating surgeon. Three below knee amputations were performed; three patients died; and three were lost to followup. Thirty-two patients were observed until union or for at least 1 year. There were no significant statistical differences between the two groups with respect to fracture type, fracture location, age, gender, or accompanying injuries. The unreamed tibial nail group showed significantly better results regarding time to full weightbearing, number of reoperations, isolated bone grafting, walking range, and average Karlström and Olerud score. Time to bony union, infection, and nonunion were not significantly different between the groups.

Adult↗
PubMed2003

Type 1B external fixation of a metacarpal fracture in an alpaca.

External skeletal fixation can be used in small ruminants as a successful, economic, alternative to internal fixation. In this case report, a type 1B frame was used on an alpaca to salvage a comminuted metacarpal fracture after failed internal fixation. Positioning the frame on the caudal aspect of the limb allowed full carpal flexion for kneeling and hence normal use of the limb throughout the recovery period. Complete healing occurred without further complications.

Animals↗
PubMedDate not supplied

Distraction osteogenesis using modified external fixation devices in five dogs.

Distraction osteogenesis was used to treat five dogs with limb deformities or limb shortening. The affected bones underwent osteotomy, and modified external fixators were attached. Complications included pin loosening, implant breakage, and soft-tissue contracture. Adequate limb length was attained in all cases, but clinical results varied from poor to excellent. Two dogs were not lame after the procedure, two dogs had improved function but were still lame, and one dog had complications necessitating amputation.

Animals↗
PubMed2000

External fixation of distal radial fractures.

From February 1995 until December 1997 we treated 48 patients aged between 26 and 79 years for distal radial fractures with external fixation. They were treated in an Arbeitsgemeinschaft fur Osteosynthestragen (A.O.) construct for periods of 5-10 weeks, the mean being 6 weeks. Forty patients were available for follow up. Our indications for this procedure were: severe comminuted displaced intra-articular fracture, severe shortening and inability to achieve fixation with other methods. The majority of patients had A.O. Classification type C fractures. Patients at follow up had objective clinical and radiological assessment as well as a subjective functional evaluation. Results were calculated using Stewart's modification of Gartland and Werley's assessment criteria. Functionally 90% achieved an excellent or good result. Radiographically 95% had an excellent or good result.

Adult↗
PubMedDate not supplied

External fixation of the lumbar spine in a canine model.

OBJECTIVE: To compare the mechanical properties of two types of external skeletal fixation of the lumbar spine with polymethylmethacrylate (PMMA)/Steinmann pin fixation in a canine unstable spine model. STUDY DESIGN: Cadaver study. SAMPLE POPULATION: Lumbar spines of 17 mature large-breed dogs. METHODS: Spine stiffness (N-m/deg) in flexion, extension, and rotation under physiological loading conditions and spine strength (N-m) in flexion were determined. Spines were destabilized at L3-L4, instrumented and retested. Fixation techniques included four-pin PMMA (PMMA4), eight-pin PMMA (PMMA8), eight-pin biplanar type I external skeletal fixator (ESF) (SK), and eight-pin spinal arch ESF (ARCHES). RESULTS: All fixation groups were as stiff as intact spines in extension and rotation and were significantly stiffer in flexion. In flexion, both PMMA8 and ARCHES were significantly stiffer than SK, and PMMA8 was significantly stiffer than PMMA4. In rotation, PMMA8 and ARCHES were significantly stiffer than SK, and in flexion to failure, PMMA8 and ARCHES were significantly stiffer than PMMA4. CONCLUSIONS: External skeletal spinal fixation (ESSF) has mechanical properties comparable to more commonly used PMMA/pin internal fixation techniques. CLINICAL RELEVANCE: External fixation of the canine spine has several potential advantages over internal fixation including minimal dissection for pin placement, the ability to span affected vertebrae with placement of implants distant from the site of injury, postoperative adjustability, and complete removal of implants after healing. This study supports the biomechanical stability ESSF of the canine lumbar spine. Further studies are indicated to evaluate zones of consistently safe and secure placement of pins and clinical efficacy.

Animals↗
PubMed1994

External fixation test in low back pain. Function analyzed in 25 patients.

We recorded the musculoskeletal performance capacity of 25 patients suffering from chronic severe low back pain before and during the external fixation test of the lumbar spine. The capacity was measured by isometric and isokinetic lifting, repetitive upper extremity lifting with a load, repetitive squatting, and the walking distance. Only walking distance was increased by fixation of the spine.

Adult↗
PubMed2005

Above-knee Ilizarov external fixation for early periprosthetic supracondylar femoral fracture--a case report.

Supracondylar femoral fractures above a total knee replacement are rare injuries that may be challenging to treat. We present a 60-year-old woman who sustained a supracondylar femoral fracture 10 days following a total knee replacement. This patient had multiple risk factors. The fracture was not deemed amenable to conventional treatment. This patient underwent fixation of her femoral fracture above a total knee replacement using a two-ring above-knee Ilizarov external fixator. This allowed full mobilization of the affected limb during fracture healing. The fixator was removed at 10 weeks, at which time the fracture was solidly healed. At the most recent follow-up, 14 months from injury, she was fully weight-bearing without walking aids and had a knee range of motion of 0-120 degrees .

Arthroplasty, Replacement, Knee↗
PubMed1996

Role of internal and external fixation in ankle fusion.

Between August 1980 and September 1993, 35 tibiotalar arthrodeses in 34 patients with primary and secondary osteoarthritis of the ankle were performed. Two different surgical techniques were employed. Internal screw fixation according to Wagner and Pock [20] and an external fixation method according to the resection compression arthrodesis by Charnley and Muller [14]. Twenty patients with 21 fusions could be investigated retrospectively. For evaluation we used self-assessment, clinical examination and radiographic analysis in combination with the score described by McGuire et al. [12]. In 80% the results were good and satisfactory with a median improvement of 23 score points on a scale of 100% 95 points, respectively. The most important advantages were pain relief and increase of walking distance. The fusion rate was 95%. We found osteoarthritis in the neighbouring joints did not have any influence on the surgical result. With respect to the two surgical techniques, the internal screw fixation method achieved fusion earlier with fewer complications and better improvement according to the McGuire score. Tibiotalar fusion is a safe therapy with reproducible good results involving pain relief, full weight-bearing and increase of walking distance.

Adult↗
PubMed1984

[An instrumented external fixation device as an instrument for measuring external fracture management].

The article deals with a method of measuring which, without changing the buildung components of the AISF-fixateur externe, determines the force at the fracture gap in the case of compression osteosynthesis. For this purpose there has been developed a ring force measuring element and expansion measuring strips. It is the aim of this measuring method to describe the course of force during the operative process of straining and to control it regarding accuracy of measuring, to superrise the forces occurring during the healing process, to be able to gauge in a definite manner in case of disturbances of the external compression system and finally to control the force attitude at the fracture gap also under dynamic load. The ring force measuring boxes can be set up at the free pipe end without changing the necessary systems of assembling. Advantages are the unlimited use, costs incurred only once, easy handling, high immunity from disturbance, the possibility of gas disinfection and no obstruction of external construction forms. With this system so far we have controlled 22 patients by means of an external compression osteosynthesis. With compression degrees at the fracture gap ranging between 400 and 800 N, one can mechanically talk of stable external osteosynthesis. With the help of bioptic material taken from the region of the direct osseous contact of a human fracture gap, the morphological signs of the primary healing of the bone could also be proved.

Equipment Design↗
PubMed1993

[Comparative tridimensional mechanical study of external fixation devices. Clinical deductions].

A tridimensional mechanical study has been carried out to compare the stabilization achievable with three types of fixators: the Ilizarov, the Orthofix and the French Army External Fixator (FESSA). The Ilizarov allows a noticeable instability persisting in every spatial plane with the exception of transverse movements. Cumbersome and unstable, this device does not seem suitable for the treatment of open fractures especially in adults. The Orthofix and the FESSA are both stable fixators. However, in compression the Orthofix tends to be transversally unstable. For diaphyseal fractures the Orthofix allows the final reduction to take place after the setting of the fixator, which is not possible with the single tube of the FESSA. Nevertheless, for epiphyseal fractures the FESSA allows many more possibilities for fixation of the fragments in every spatial plane. Both the Orthofix and the FESSA allow an axial mobilization and dynamisation; but the FESSA is the only one that allows a multidirectional dynamisation.

Biomechanical Phenomena↗
PubMed2001

Management of pertrochanteric fractures in the elderly patients with an external fixation.

One hundred patients above 80 years of age (mean age 88.20 years) with 101 fractures in the area of the trochanters were managed with an external fixation (Orthofix pertrochanteric fixator, OPF) from October 1995 to March 2000. Osteosynthesis was performed under radiology control and especially after a satisfactory closed reduction had been obtained. Accompanying diseases, duration of surgery, the transfused blood units, duration of hospitalization, complications, walking ability, time to union and mortality rate were recorded pre-operatively and post-operatively for a year. The results were: fast operation time (19.6 min at average), minimal blood loss (no blood transfusion was needed for 85 patients whereas for the remaining 15 patients 29 blood units were administrated due to a pre-existing anemia and not to compensate blood loss during surgery) and short duration of post-operative hospitalization (5.27 days at average). The main complications that were recorded were sore wounds in 15%, inflammation in the entrance of the screws in 9%, and aseptic loosening of the femoral screws/loss of reduction in varus >10 degree in 8%. These complications did not prevent the union of the fracture to a satisfactory level (13.91 weeks at average). There were no revisions. Within the first post-operative semester, the majority of the patients (57.69%) returned to the walking condition they had before the fracture. Post-operative mortality during the first month was 15% whereas during the first post-operative semester the rate increased by 7%. Due to the design of the device, the method is simple, fast, does not derange the patients and requires short time of hospitalization. These advantages are especially useful for the treatment of elderly patients with aggravated general condition.

Age Distribution↗
PubMed1995

Stress protection due to external fixation.

Bone is sensitive to mechanical influences. The presence of an orthopaedic device will impose constraints on the mechanical environment that may influence subsequent remodelling and repair. An Oxford External Fixator was applied to six intact ovine tibiae. The strains engendered during normal walking were then recorded from strain gauges applied to the mid-shaft of the bone. The fixator configuration was then altered such that the intact fixator bar connecting the pins was replaced with a sectioned version that did not permit load transfer through the fixator, and the strain environment re-recorded. The peak strains recorded with the intact bar were significantly lower than those recorded with the sectioned bar. This showed that the use of a fixator with an intact bar resulted in significant stress protection of the underlying bone. A fixator was then applied to both the right and left tibiae of a further six animals and the resulting strain environment and corresponding remodelling response was observed over 16 weeks. In each case one fixator was configured with an intact bar (the stress protected limb), whilst the other utilised a sectioned bar (the unprotected limb). The results showed that over this period the bone mineral content fell by 9% in the stress protected limb compared to the unprotected limp. Quantitative assessment of the bones showed that this bone loss occurred as a direct consequence of resorption on the periosteal and endosteal surfaces. In addition, strain recordings at week 16 showed that the fixator was still stress protecting the tibia.

Animals↗
PubMed1996

Correction of persistent clubfoot deformities with the Ilizarov external fixator. Experience in 10 previously operated feet followed for 2-5 years.

We reviewed the outcome in 10 idiopathic clubfeet in 7 patients treated with the Ilizarov external fixator (IEF) for persistent foot deformities after previous surgery. After follow-up of a median of 40 (25-56) months, 6 patients/parents were satisfied with the results and most of them reported better walking capacity and fewer problems finding shoes that fit. Severe equinus deformity was seen in 9/10 feet prior to treatment in the IEF and in no foot at follow-up. However, persistent reduction of ankle joint motion, limited walking capacity and intermittent pain were commonly found.

Adolescent↗
PubMed1994

Use of the unilateral external fixator (monofixator) in fracture treatment: experience in 50 fractures.

From 1988 to 1992, a total of 50 fractures with associated soft tissue lesions were treated with a unilateral external fixator (monofixator). The location of the fracture was the tibia in 39 cases, the pelvis in 5 cases, the femur in 4 cases, and the ankle and the humerus in 1 patient each. There were 22 open fractures (56%). Unproblematic healing with the monofixator was achieved in 69.2% of tibial fractures after a mean healing time of 18.2 weeks. Axial dynamic compression was performed in 18 tibial fractures. Planned reosteosynthesis was performed in 8 tibial fractures (20%). No late problems were seen after secondary internal osteosynthesis. Complications with the monofixator in tibial fracture treatment were refracture in 3 patients, pin track infection in 3 patients and hypertrophic pseudarthrosis in 1 patient. The monofixator provides safe and stable fixation in lower limb fractures with severe associated soft tissue trauma. In unstable pelvic and femoral fractures, satisfactory reduction and stabilisation can be achieved, mostly lasting until definitive osteosynthesis is possible.

Adolescent↗
PubMed1989

Development and clinical application of an external fixator monitoring system.

A monitoring system for measuring movement occurring in a dynamic external fixator used to treat fractures is described. The system measures shortening during fracture healing, micromovement at the fracture site on weight bearing and detects pin loosening. The method of calibration including cadaver experiments is presented. The clinical application is described and the reasons for measuring movement are discussed.

Bone Nails↗
PubMed2003

Use of external fixation to correct deformities of the lower leg.

With the development of modern external fixation by Ilizarov and the modifications that have been made to his method, we now have another tool with which to surgically address a deformity of the lower extremity. It is widely recognized that a malaligned lower extremity is a major cause of the development and progression of arthrosis of the hip, knee and ankle. Early recognition of a [figure: see text] malaligned limb or joint, coupled with proper preoperative planning and realistic patient expectations, may significantly reduce the incidence of arthrosis and improve the overall quality of life for the patient.

Adult↗