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Results for “External Fixators”

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PubMedDate not supplied

A protective orthoplast splint in the treatment of a patient with Colles' fracture by external fixation.

Discussion is provided of an Orthoplast splint that was used to aid in the successful treatment of a mentally deficient patient who had sustained a fracture in the distal forearm, which was managed by external fixation. This splint is advocated for the treatment of various types of uncooperative patients. Although this splint has not been tried in the treatment of children, it appears likewise applicable for a noncompliant youngster.

Aged↗
PubMed1993

Use of the external fixation apparatus for percutaneous insertion of pins in the distal one-third of the radius: an anatomic study.

OBJECTIVE: To assess the risk of soft-tissue injury during percutaneous placement of external fixation pins in the proximal radius. DESIGN: An anatomic study with embalmed cadaver limbs. SETTING: Hand and upper limb centre at a university-affiliated hospital. INTERVENTIONS: Two 4-mm Hoffman half pins were percutaneously placed along the dorsoradial ridge of the radius, four finger breadths proximal to the radial styloid process. MAIN OUTCOME MEASURES: Injuries to soft tissues including tendons, nerves and vessels were noted. RESULTS: Nerve or tendon injuries occurred in 7 of 26 forearms. Three pins transfixed either the superficial branch of the radial nerve or lateral antebrachial cutaneous nerves. Tendon injuries included the brachioradialis in two forearms, the extensor carpi radialis brevis in three forearms, and the extensor carpi radialis longus and the abductor pollicis longus in one forearm each. CONCLUSIONS: Percutaneous pin placement in the distal radius is unsafe. The authors recommend open pin placement for fractures of the distal radius.

Bone Nails↗
PubMed2005

Treatment of segmental tibial defects using acute bone shortening followed by gradual lengthening with circular external fixator.

The aim of this study was to clinically and radiographically evaluate acute bone shortening followed by gradual lengthening in the treatment of large segmental tibia defects induced in seven clinically normal dogs. A circular external fixator was assembled with one proximal 5/8-circle ring, one middle ring and one distal ring connected with three rods. Thirty per cent of the tibia and fibula were removed in the middle and distal parts of the diaphyses, between the middle and distal rings. Acute bone shortening with compression of proximal and distal segments was performed. A subperiosteal osteotomy was performed between the half-ring and middle ring. Bone distraction started 7 days after surgery; after lengthening, the apparatus was left in place for 14 weeks for consolidation of regenerated bone. The frame was removed at the end of this period, and the dogs observed for four more weeks. Functional results were considered excellent in two, good in three and fair in the other two dogs. Bone regeneration within the distraction gap was obtained 14 weeks after neutral fixation period. We concluded that acute bone shortening followed by gradual lengthening by Ilizarov method can be used to treat extensive tibial defects in dogs, although it presents limb temporary abnormal limb shape and unequal length as early disadvantages.

Animals↗
PubMed1983

External fixation of complex hand and wrist fractures.

From 1977 to 1980 fixation with an external fixateur was performed in 33 injuries of the upper extremity: ten fractures of the hand, 22 Colles' fractures, and one osteotomy for Madelung's deformity. Application was primary in 19 patients and after another type of fixation (cast or Kirschner wire) had failed to hold reduction in 14 patients. All ten hand fractures healed in 4 to 12 weeks, and the distal radius fractures united in 6 to 10 weeks. The external fixateur for unstable fractures of the hand and wrist with bone or soft-tissue loss provides rigid skeletal stabilization, accessibility for wound care, and early joint mobilization.

Adolescent↗
PubMed1995

Extra-articular fractures of the distal radius in young adults. A technique of closed reposition and stabilisation by mono-segmental, radio-radial external fixator.

Some fractures of the distal radius need an operative treatment in order to restore and maintain both length and anatomical angles of the distal joint surfaces. We present a technique of closed reposition and stabilisation by external fixator on the distal radius, without any bridging of the wrist joint, allowing for active and passive motion of the wrist during bone healing. Two cases are illustrated as examples.

Adolescent↗
PubMed1994

The results of external fixation of the radius in the treatment of comminuted intraarticular fractures of the distal end.

14 unstable comminuted intraarticular fractures of the distal radius were treated by the use of the A/O mini-external fixator. The distal pins were inserted in the distal fragment, thus leaving the wrist joint free to mobilize. Clinical results were assessed at 3 to 12 months using the Sarmiento demerit point system. Nine were male and five female, with a mean age of 37 years. Ten fractures were closed and four were open. 11 patients (78.5%) had an excellent functional score and three (21.5%) had a good score. All patients had normal wrist morphology with an average radial length of 11 mm, radial angle of 23 degrees and a mean volar angle of 12 degrees. 12 patients had anatomical radio-carpal and radio-ulnar joints and two patients had a step less than 2 mm at the radio-carpal surface. This method has proved in our experience to be reliable in maintaining the position as well as allowing early functional recovery.

Adolescent↗
PubMed1991

External fixation of extremity flaps and grafts.

Positioning extremities after soft-tissue reconstructive procedures can be difficult, particularly when flaps or skin grafts have been placed for posterior or circumferential defects. We describe a method using the patient's existing external fixator, when present, to aid in the postoperative care and positioning of the patient.

Adult↗
PubMed1997

[Advantages of the unreamed tibial nail in comparison with external fixator in treatment of grade 3 B open tibial shaft fractures].

Between 1987 and 1993, 41 grade 3B open tibial shaft fractures were treated with the unreamed tibial nail (URTN n = 22) or an external fixator (FIX n = 19). The method of treatment was left to the choice of the operating surgeon. Three below the knee amputations were performed, three patients died, and three were lost to follow-up. In all, 32 patients were followed up to union or at least for 1 year. There were no significant statistical differences between the two groups (P < 0.2, chi-squared, t-test) with respect to fracture type, fracture location, age, gender or accompanying injuries. The URTN group showed significantly better results regarding time to full weight-bearing (URTN 11 +/- 4 weeks; FIX 20 +/- 11 weeks, P < 0.01 M-W) Mann-Whitney Test, number of reoperations (URTN 1.04; FIX 2.89; P < 0.01 M-W), isolated bone grafting (URTN 3/22; FIX 8/19; P < 0.05 chi-squared), and average Karlström and Olerud score (URTN 30 +/- 4; FIX 26 +/- 5; P < 0.05 M-W). In all, 15/17 URTN patients and only 6/15 FIX patients achieved unlimited walking distance (P < 0.01 M-W). Time to bony union, infection, and nonunion were not significantly different between groups.

Adult↗
PubMed2002

Stage 3 Kienböck's disease: reconstruction of the fractured lunate using a free vascularized iliac bone graft and external fixation.

Eighteen patients with stage 3 Kienböck's disease were treated by débridement of the necrotic core of the lunate and implantation of a free vascularized corticocancellous iliac bone. The wrist was stabilized with an external fixator during healing. The efficiency of the procedure for restoring the structure of the fractured lunate, preventing carpal collapse and improving the clinical outcome was assessed at a mean follow-up of 5 years. The graft became incorporated in the lunate in 16 of the 18 patients and no fracture of the reconstructed lunate or carpal collapse occurred in these cases. The graft did not integrate and was resorbed in the other two patients.

Adolescent↗
PubMed1991

Application of sulcated half-ring external fixator for treating bone and joint injuries of burned lower extremities: a report of four cases.

Four patients with burned lower extremities complicated with severe bone and joint injuries were treated with sulcated half-ring external fixators. The results were satisfactory. This apparatus is simple, easy to handle and effective. Using this fixator, the burn wounds as well as the bone and joint injuries could be managed at the same time, without mutual interference. As it seems a desirable method for the management of such compound injuries, the advantages and disadvantages of this apparatus are discussed.

Adult↗
PubMed1991

External fixation for intra-articular fractures of the distal radius.

In a prospective study of 132 patients with an average age of 35 years, unstable intra-articular fractures of the distal radius were treated by external fixator. Only 15 cases required limited open reduction. Follow-up was for a mean of 42 months. There were few complications and 83% of patients had good or excellent results. There was a statistically significant correlation between the severity of the fracture and the clinical outcome, irrespective of radiological restoration. Articular and soft-tissue damage following violent compressive forces may lead to a degree of functional impairment.

Adolescent↗
PubMed1994

Preservation of the first ray in a diabetic patient with a penetrating ulcer and arterial insufficiency by use of debridement and external fixation.

Successful preservation of the first ray was achieved in a diabetic patient with a penetrating ulcer with underlying osteomyelitis of the first metacarpophalangeal joint and arterial insufficiency. Resection of the joint followed by stabilisation using an external fixator for four weeks resulted in permanent control of infection and preservation of the toe without recurrence of osteomyelitis or ulceration. Since preservation and correct alignment of the first ray is essential for foot stability, this technique may be beneficial in young and active diabetic patients suffering from this difficult complication of their disease.

Debridement↗
PubMed2001

Dynamic external fixation for pilon fractures of the interphalangeal joints.

Eight consecutive pilon fractures of the finger proximal interphalangeal joint and one of the interphalangeal joint of the thumb were treated by closed reduction and application of a new dynamic external fixator. The average range of movement achieved was 12 degrees -88 degrees and there were no serious complications. The technique described offers an effective and simple solution for treatment of pilon fractures of the interphalangeal joint.

Adolescent↗
PubMed1992

Internal versus external fixation of bicondylar tibial plateau fractures.

Comminuted bicondylar tibial plateau fractures remain a difficult problem for the orthopaedic surgeon. Treatment has ranged from traction to cast immobilization to open reduction and internal fixation; none of these has emerged as ideal. Recently, one of the senior authors (DJC) used a technique of indirect reduction followed by application of a hybrid circular external fixator, noting a stability similar to that of an open reduction and internal fixation but with fewer complications. This paper reviews both the authors' experience and citations from the literature with regard to this problematic fracture.

External Fixators↗
PubMed1994

[Retrospective analysis of consecutively treated distal radius fractures with the external fixator].

The purpose of this study was to determine retrospectively some subjective and objective parameters following the operative treatment of 32 patients with "complex" (intraarticular and/or comminuted) fractures of the distal radius using the small AO external fixation device. The mean follow-up period was 20 months (minimum 4, maximum 48) and the mean age of the subjects was 62 years (minimum 27, maximum 91). Subjective results such as "general feeling", mobility, strength and pain, expressed with a scoring system (% of maximum obtainable points), showed an overall good result and ranged between 71% (pain), 81% (strength) and 91% (mobility and "general feeling"). Regarding the objective results, no major skin or soft tissue distress (Sudeck dystrophy) was noted. However, there was a general tendency towards a mobility deficit of the wrist operated on, which was statistically significant (P < 0.01) for flexion, extension, supination and abduction (respectively, -17.7%, -12.4%, -7.1% and -12.5%). The late standard radiological and lateral controls showed a mean radial angle of +2.13 degrees (B or lateral radial angle) and +23.13 degrees (A or AP angle), respectively. The analysis of data, as expressed by time after operation (< or > than 10 months), showed no relevant difference between the two groups (age of both similar), as expressed by age (< or > than 60 years); the data only showed differences in strength and pain (scores by 92% vs 82% for force and 92% vs 76% for pain) and in flexion and extension (-22.8% and -14%, P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗