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At least 1,135 records · Page 63Linked to original sources
PubMed1991

Bone mineral loss after Colles' fracture. Plaster case and external fixation equivalent.

The bone mineral content of the radius and ulna was analyzed in 31 postmenopausal women with displaced Colles' fractures. Sixteen fractures were treated with a below-the-elbow plaster case and 15 with primary external fixation. The bone mineral content of the forearm bones was measured with a photon absorptiometer 9 (6-24) months later. There was a mean 15 percent mineral decrease in the radius, but no difference between the two treatment groups. The decrease did not correlate with the age of the patient, nor was there any correlation with grip strength or range of wrist motion. The more severe fractures, according to the Frykman classification, had a more pronounced mineral loss than the simpler fractures.

Aged↗
PubMed1993

[Joint bridging external fixation of fractures of the distal lower leg with severe skin damage].

During the 36 months from April 1989 until April 1992, 34 fractures of the lower end of the leg were treated by joint bridging application of external fixation using the so-called ".. Kugelspannfixateur UNIFIX". They were: 24 intraarticular compression fractures, seven bimalleolar dislocation fractures, two shot fractures and one postoperative empyema. All demanded treatment urgently. Because of severe skin lesions or because of medical reasons, neither osteosynthesis nur conventional conservative methods could be used. With the aid of UNIFIX, good alignment was achieved in all cases and practically always maintained as long as necessary. Reduction of joint-bearing fragments was equally good as with ligamentotaxis. All skin lesions healed during the time of fixation. Only two infections of screw tracks were observed. Additional operations like primary minimal osteosynthesis or later reconstructive surgery could be carried out with the fixateur in place. They have improved the results. No severe damage to the subtalar joint was observed. Therefore this principle of treatment can be recommended providing right indication.

Adult↗
PubMed1991

[Application of Ilizarov's external fixator on the basis of biology].

Ilizarov's biology includes that, in the presence of tension and stress, both regeneration of bone and soft tissues with cellular proliferation and their biological synthesis become vigorous. The Ilizarov's external fixator has five functions namely: compression, distraction, de-angulation, derotation and translocation. The principles of this procedure include: corticotomy instead of conventional osteotomy, placement of 4-5 sets of 1.5 mm wires transfixed in the bones at different levels under tension of 70-110 kg on the circular rings without acute diastasis until the 5 th to 7th day, and then, callotasis-callus distraction. The quality and quantity of the regenerated bone within the widening distraction gap are closely related to the maximum preservation of bone marrow and periosseous blood supply, and a distraction of 1 mm per day and preferably done by 4 times 0.25 mm each time should be emphasized. Experiences in 17 cases of pseudarthrosis and unequal length of leg treated with Ilizarov's technique are presented.

Adolescent↗
PubMed1986

Fractures of the shaft of the tibia treated with Hoffmann external fixation.

Ninety-six compound or unstable fractures of the tibial shaft were treated with external fixation of different mountings. The median healing time was 10 months without a statistically significant difference between the healing time after treatment with unilateral frames and quadrilateral frames. The rate of pin-track infection was 36%, which is comparable to those of other published series. Seven cases of chronic osteitis and four pseudarthroses required further surgical management. We had no primary or secondary amputations in this series.

Female↗
PubMed1988

Comparative study of the Orthofix and Pittsburgh frames for external fixation of unstable pelvic ring fractures.

We compared the mechanical performance of the Orthofix pelvic external fixator with that of the Pittsburgh triangular frame (PTF) on eight fresh-frozen cadaver pelves with experimentally created Malgaigne (double-vertical) fracture/dislocations. The pelves were quasi-statically loaded in longitudinal compression and loss of reduction (i.e., failure) was defined as 1.5 cm of diastasis at either of the fracture/dislocation sites. The Orthofix frame-pelvis complex (four 6-mm half-pins) was comparable to the PTF-pelvis complex (eight 5-mm half-pins) in terms of load to failure and overall stiffness, but was 4-7 times stiffer at lower load levels. Both frame-and-pin complexes deformed moderately at the pin-bone interface, but, while the PTF also showed moderate displacement between frame components, the Orthofix had almost no frame intercomponent motion.

Adult↗
PubMed1986

Biomechanical studies of an anterior pelvic external fixation frame intended for control of vertical shear fractures.

Biomechanical testing of an experimental pelvic external fixation frame incorporating a large tubular horizontal member was carried out on formalin-fixed cadaver pelves with simulated vertical shear injuries. The device was tested with 5 mm standard and 6 mm experimental pins, and was compared to a Pittsburgh triangular (PT) frame constructed of standard Hoffmann components. Tested by vertical loading, the experimental frame with 5 mm standard pins was 1.9 times as stiff as the PT frame, and with the 6 mm experimental pins it was 2.4 times as stiff as the PT frame. Clinical trials are needed to determine efficacy in vivo.

Aged↗
PubMed2005

The care of pin sites with external fixation.

Two protocols for the operative technique and care of the pin-site with external fixation were compared prospectively. There was a total of 120 patients with 46 in group A and 74 in group B. Infection was defined as an episode of pain or inflammation at a pin site, accompanied by a discharge which was either positive on bacterial culture or responded to a course of antibiotics. Patients in group B had a lower proportion of infected pin sites (p = 0.003) and the time to the first episode of infection was longer (p < 0.001). The risk of pin-site infection is lower if attention is paid to avoiding thermal injury and local formation of haematoma during surgery and if after-care includes the use of an alcoholic antiseptic and occlusive pressure dressings.

Bone Nails↗
PubMed1989

[Osteosynthesis of the clavicle using an external fixator].

Twenty-four fractures or nonunions of the clavicle were treated by a Hoffmann external fixator, for selected indications. No vascular or pleural complications were observed. All clavicles healed, after a mean duration of 52 days.

Adolescent↗
PubMed1987

Dynamic external fixation for comminuted intra-articular fractures of the distal end of the radius.

An external fixation device that allows motion of the wrist was developed for the treatment of severely comminuted intra-articular fractures of the distal end of the radius, and in specimens from cadavera that motion was demonstrated with the device in place. Thirty patients who had thirty-two comminuted intra-articular radial fractures were then treated with fixation using this device during a six-month interval. Thirty-one of the wrists were examined at follow-up one and two years later. The first fifteen wrists that were allowed full flexion and extension immediately postoperatively had lost some volar tilt postoperatively. The other patients, for whom only flexion was allowed immediately postoperatively, while extension was allowed four weeks later, did not lose volar tilt. The device maintained the reduction of the fracture fragments and allowed the early return of a functional range of motion of the wrist.

Adolescent↗
PubMed1993

Treatment of difficult PIP joint fractures with a mini-external fixation device.

Closed intra-articular proximal interphalangeal (PIP) joint fractures--often with accompanying joint subluxation--constitute a difficult treatment problem. This article presents an alternative method consisting of closed treatment of complex PIP joint fractures with a mini-external fixator. The method utilizes the traction principle without necessitating a complex outrigger system. Immobilization is reduced to 3 weeks and monitored with a mini-fluoro unit. The three cases presented had 1- to 2-year follow-up and excellent clinical results despite suboptimal roentgenographic appearance.

Adult↗
PubMed1999

Wrist ligament strain during external fixation: a cadaveric study.

The purpose of this study was to evaluate the change in strain (elongation) that occurs in 2 extrinsic ligaments of the wrist (volar radioscaphocapitate and dorsal radiotriquetral) as the wrist is sequentially distracted with an external fixator. Six fresh cadaver specimens were dissected to expose the dorsal radiotriquetral and volar radioscaphocapitate ligaments. A differential variable reluctance transducer strain gauge was applied to both ligaments and the wrist was serially distracted in increments of 5 mm with an Agee WristJack (Hand Biomechanics Laboratory, Sacramento, CA). The distraction increments were measured on the WristJack. X-rays were obtained at each level of distraction. At 10 mm of WristJack distraction, the strain in both the volar radioscaphocapitate and dorsal radiotriquetral ligaments increased to greater than 20%. An increase to a 0.63 carpal height index resulted in an increase in strain of 20%. This increased strain may contribute to wrist stiffness.

External Fixators↗
PubMed1993

[A new external fixator for treatment of unstable distal radius fracture].

Unstable distal radius fractures cannot be immobilized in a plaster cast: mal-unions (and later arthrosis of the wrist) are the result. Most symptoms are attributable to the shortening of the radius. Retention by means of an external fixator is the therapy of choice in such cases. Various fixator systems have become known. In this paper, a new fixator is presented which has the following advantages: It is very mobile and adaptable, and corrections are possible after attachment of the fixator. The screws can be inserted depending on the anatomical situation. The fixator is handy and light. The fixator has proved its effectiveness for a long time and is also suitable for complicated wrist injuries.

Bone Wires↗
PubMed2004

Use of emergency room external fixator in provisional reduction of posterior malleolar fractures.

Closed reduction is an important initial step in managing ankle fractures. Although the majority of ankle fractures can be managed with closed reduction, the posterior malleolar fracture is often unstable. Posterior malleolar fractures may result in persistent posterior ankle dislocation with compromise of the soft tissue surrounding the joint. Persistent dislocation is best treated with urgent open reduction and fixation to protect the cartilage and surrounding soft tissues and to allow for ease of reduction at the time of surgery. We describe a technique for placing an emergency room external fixator for provisional reduction of the unstable posterior malleolar fracture. This technique allows for early reduction of unstable posterior malleolar fractures and avoids the need for urgent operative reduction.

Adult↗
PubMedDate not supplied

[External fixators in the treatment of fractures and fractures/luxations of the pelvis].

Combined fractures of the two pelvic arches and severe disjunction of the pubic symphysis are acute lesions which are difficult to treat; in order to avoid poor functional results, the use of external fixatives have now become a routine orthopedic surgical practice. Two cases are reported to illustrate the large numbers of patients treated by the Orthopedic and Traumatological Division of the Ospedale Civile in Alessandria.

Adolescent↗
PubMed1998

Dynamic external fixation for injuries of the proximal interphalangeal joint.

Pain, stiffness, instability and degenerative arthritis are common sequelae of complex fracture-dislocations of the proximal interphalangeal (PIP) joint. Operations were carried out to obtain stability, followed by application of a dynamic external fixator in 20 patients with a mean age of 29 years. This provided stability and distraction, and allowed controlled passive movement. Most (70%) of the patients had a chronic lesion and the mean time from injury to surgery was 215 days (3 to 1953). The final mean range of movement was 12 to 86 degrees. Complications included redislocation and septic arthritis, which affected the outcome. Four pin-track infections and two breakages of the hinge did not influence the result. The PIP Compass hinge is a useful adjunct to surgical reconstruction of the injured PIP joint.

Adolescent↗
PubMed1993

Mechanical performance of external fixators with wires for the treatment of bone fractures--Part II: Wire tension and slippage.

The work shows correct procedures needed in order to gather reliable data from measurement of displacements versus axial load in a laboratory mounting of the Ilizarov external fixator. The mechanism of settling after load cycling is investigated. Detension under load is a major problem of wires. By means of vibration frequency measurements, tests on single wire allow determination of reduction in wire tension due to transverse loading: it is found that, almost independently from the amount of clamp tightening, the tension reaches a lower limit related only to the transverse load and not related to pretension. It is shown that, for higher clamp tightening torques, wire detension must be attributed to permanent plastic deformation of the wires; moreover, it is shown that the unavoidable errors in the spacing of the tensioned wires lead to marked decrease of their stiffness under transverse load.

Biomechanical Phenomena↗
PubMed2003

The effect of clamping a tensioned wire: implications for the Ilizarov external fixation system.

This study demonstrates that clamping a tensioned wire can cause a reduction in wire tension. Tension (about 1275 N) was applied to a wire that was subsequently clamped, using cannulated bolts, to the steel half-ring of an Ilizarov external fixator. The tension in the wire was monitored before, during and after clamping. The apparatus was disassembled and the deformations in the wire caused by the clamps were measured. This experiment was repeated 15 times. When the wire was clamped to the frame, the wire tension was reduced by 22 +/- 7 per cent (mean +/- standard deviation, SD). The drop in wire tension was linearly correlated (r = 0.96; p < 0.001) with the deformation caused by the bolts. A finite element (FE) model of the wire was also constructed. The model was pre-stressed (tensioned), and the clamping effect replicated. This analysis showed that clamping the wire could be considered to squeeze the wire outwards (like toothpaste from a tube) and so reduce its tension during fixator assembly. To assess the magnitude of this effect in the clinical situation, the FE model analysis was repeated to replicate clamping a 1.8-mm-diameter wire to a 180-mm-diameter steel Ilizarov ring component. The analysis showed that for these conditions the tension reduced by 8-29 per cent. The results of this study highlight a general engineering problem: how can a tensioned wire be secured to a structure without an appreciable loss of tension? If the performance of the structure depends on the wire tension, this performance will change when the wire is secured.

Bone Wires↗
PubMed1985

External fixation of infected non-union of the femur.

A one-stage method of treating infected non-union of a fracture of the femoral shaft is described. The method involves excision of dead and infected tissue, resection of bone ends, cancellous bone grafting and fixation with an external frame. Four out of five cases were successful within 7 months.

Adult↗