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At least 1,315 records · Page 73Linked to original sources
PubMed1987

Study on the external fixator in the treatment of the fractures of the inferior end of the two bones of the adult's forearm. Report of fifty-five cases.

The authors report 55 cases of fracture with significant displacement of the distal end of the radius. In 30 cases, there were, moreover, lesions of adjacent bones and in 18 cases, lesions of the soft tissues. The fractures were treated by Hoffmann external fixator placed either immediately or later on, after the failure of conservative treatment. Thirty-four cases, reexamined within a period of at least six months, were used to show the results according to the criteria of Castaing. The overall results show 3 perfect results, 23 satisfactory ones and 8 quite satisfactory. The main complication of this series is frequent algodystrophy in the first cases. This has practically disappeared since much less traction is applied to the fracture site.

Adult↗
PubMed1990

External fixation for open tibia fractures. A management strategy.

The management of open tibia fractures with the Dynamic Axial Fixator, including the method of application and postoperative care, is described. This fixator is utilized until healing. Weight bearing and axial fracture site movement promote an early callus response. The results obtained in the first 35 cases in which it was used at our institution are presented. Thirty-three of the fractures were successfully treated until healing in the external fixator.

Fracture Fixation↗
PubMed1984

[Fatigue performance of Hoffmann-Vidal external fixator].

The question concerning reusability of the Hoffmann-Vidal frame has been widely discussed, but no definite recommendation can be made on scientific data. The present study was designed to investigate the change of frame stiffness and fatigue life of the components in a Hoffmann-Vidal quadrilateral fixator. Failures were found at the base of the pin fixation bracket rod. They can be classified into 3 types: complete rod fracture, incomplete rod fracture and loosening of the rod. Only complete fractures of the rod caused a significant reduction of frame stiffness. Strength and loosening torque were proportional to the initial tightening torque for both the universal ball joint and articulation coupling. The mean reduction of screw fixation strength was 16% after 2.5 million cycles. As a result of repeated tightening, two retaining screws from three universal ball joints were severely deformed and the threads flattened. Two fixation screws on the pin bracket and two square-headed screws on the adjustable connecting rods fractured at the 5th to 6th tightening sequence. Significant wear debris were observed during repeated tightening of the articulation coupling. No gross material defects were observed on the fracture surfaces of the failed components. The Hoffmann-Vidal external fixation apparatus may be safely used for four to five sequential applications provided that all critical components be carefully inspected and the fixation screws replaced after each application. The screws should be tightened appropriately using only the T-wrench in order to prevent overloading. These screws should be retightened periodically to maintain incorporated to minimize the screw and rod fractures and to avoid the wear problem after repeated tightening of the screws.

Biomechanical Phenomena↗
PubMedDate not supplied

[Staged reposition and fusion with external fixator in spondyloptosis].

PROBLEM: Is the staged reduction by an external fixateur and combined fusion of slipping vertebra an adequate surgical treatment for lumbar spondyloptosis? METHODS: 11 patients with symptomatic lumbar spondyloptosis were treated using a technique of slow reduction and combined posterior and anterior approach. The first stage consists of a posterior approach with the application of the external fixateur. After staged reduction the anterior and posterior fusion are performed. All patients were pre- and postoperatively classified by radiological and clinical criteria. We report improvements in pain, activities of daily live, and cosmetic appearance. The average follow-up was over three years. RESULTS: Postoperatively one patient failed to reduce, and one developed a subsequent L4/L5 spondylolisthesis. All patients showed a solid spondylodesis with no significant loss of reduction. There was no patient with any neurological deficit. The mean correction of the slipping at follow-up was 84.5%. 9 patients were satisfied with the result. CONCLUSION: With gradual instrumented reduction by external fixateur, an anatomic reduction is nearly obtained and excellent clinical results in the treatment of spondyloptosis can be achieved.

Adolescent↗
PubMed1993

[Structure of external fixators].

Authors described the development of the construction of fixateur externes supported by historical facts, analyse the biomechanical problems of the fixateur osteosyntheses, illustrated by drawings. They propose mountings, of modern montage proving its rightness. Finally a collection of synonyms is given to clear the nomenclature of the several montages.

External Fixators↗
PubMed1983

External fixation for arthrodesis of the knee and ankle.

In a series of 74 knee and ankle arthrodeses the Vidal-Adrey quadrilateral mounting of the Hoffmann device was employed for arthrodesis of the knee in 50 cases. Union occurred in 80%. The union rate was highest (86.2%) when arthrodesis was attempted for infection after total knee arthroplasty. The complication rate was 24%. Most of the complications were related to pin sites. In eight patients knee arthrodesis was performed by multiplanar pin insertion and external fixation with either the Hoffmann or Fischer device; union occurred in all patients; pin site infection occurred in one. In 13 tibiotalar arthrodeses a modified quadrilateral frame was utilized, sparing the subtalar joint; union occurred in all of these cases. For tibiocalcaneal arthrodesis, attempted in five patients, a triangular mounting based on pins placed through the tibia, calcaneus, and metatarsals was necessary. Union occurred primarily in four of the five patients. This study indicates the superiority of multiplanar pin insertion for knee arthrodesis for treatment of failed total knee arthroplasty. The use of larger pins manufactured from relatively nonreactive metal alloys seems to decrease the incidence of pin site problems.

Ankle Joint↗
PubMed1982

[Observations on bone injuries in aviation. Indications for treatment of more complicated fractures with external fixators. Clinical examples].

Air force injuries and statistics from airport first-aid stations confer on aviation traumatic pathology a position of some significance, though in general terms the percentages involved are much the same as those associated with an ordinary occupation and revealed by an ordinary epidemiological investigation. Attention to special areas, however, such as parachuting, makes it clear that injuries, particularly bone fractures, exact a considerable toll. Aircraft accidents form the major field. Reference is made to subjects with multiple injuries and the indications for external fixators. These offer certain advantages (minimal applicative injury, facilitation of dynamic osteosynthesis), and disadvantages (problems of anchorage to the bone, and biomechanical and technical problems). The so-called "omnidirectional" fixator enables these disadvantages to its credit: employment of conventional and special grasping elements, easy and precise application, with the possibility of carrying out unidirectional adjustments and electronic checking of the forces applied.

Aerospace Medicine↗
PubMed1985

Salah Eddin external fixation system: a bone slider and compressor.

This study involves 65 patients with severe war injuries to the extremities where all conventional and available lines of treatment have failed or a decision of amputation has been made. Twelve humeri, 45 tibiae and eight femura were studied. The sliding system was used on 39 patients and the compressor system on 26 patients. In the sliding system, gaps ranged from 2 cm to 12 cm. In the compressor system established nonunion, failed bone graft operations, infected pseudarthrosis and gaps less than 2 cm were studied. Salah Eddin external fixation systems, both sliding and compressor, were found to be efficient, biomechanically adequate, easy to apply and remove and able to replace considerable gaps with no risks of open surgery.

Adult↗
PubMed1982

[Therapy of hand joint fractures using the external fixator. Experiences - results].

In the treatment of multi-fragment fractures of the base of the radius plate osteosynthesis using the small-fragment instrument set is preferred to conservative treatment due to the superior results achieved. However, one still cannot dispense with an additional immobilization of the fracture in a plaster cast. The extension of intra-articular comminuted fractures of the base of the radius is a technically relatively simple procedure and does not require a supporting plaster cast. In this paper we report the results of the treatment of twenty-seven wrist-fracture patients who were treated by external fixator. We also describe the indications and operative techniques. The results are reported by functional and radiological findings. For a great number of cases the results were quite good. We can highly recommend this procedure in the treatment of wrist injuries due to the simplicity of the operative technique employed and minimal follow-up treatment needed in conjunction with the good results achieved.

Adult↗
PubMed1994

Dorsal pin placement and external fixation for correction of dorsal tilt in fractures of the distal radius.

Insertion of a dorsal fixation pin was performed in 10 patients treated for distal radius fractures associated with dorsal angulation of the distal fragment. These fractures did not improve position with direct traction. Reduction was achieved with the use of a dorsal pin, used as a lever, to correct dorsal tilt of the fracture and to reestablish anterior angulation of 10 degrees in the distal joint surface of the radius. The dorsal pin was then fixed to an external fixator bar. All of these fractures healed in good position with appropriate alignment and without complications.

Adult↗
PubMed2006

Prophylactic external fixation and extensive bone debridement for chronic osteomyelitis.

There is universal agreement that treatment of osteomyelitis should consist of debridement, obliteration of dead space, tissue coverage and antibiotic therapy, with debridement as the most important factor for therapeutic success. Four patients, 27 to 72 years old, with chronic osteomyelitis after a fracture of the femur (two), or of the tibia (two), were included in this study. The patients had already undergone 5 to 15 (mean: 9) surgical procedures. The same surgical technique was used in all of them: sinuses were carefully excised down to the bone, and necrotic bone was aggressively resected until normal bleeding was seen. A prophylactic circular external fixation frame, built on one proximal and one distal ring connected to the bone by thin wires and half pins, was used to protect and support the limbs, significantly weakened by radical debridement. Bone grafting or distraction osteogenesis was not necessary. All wounds healed without complications, and the infection did not recur. The average follow-up period was 43 months (range: 38 to 54).

Adult↗
PubMed1989

[Use of unilateral external fixation in pediatric femur shaft fracture within the scope of polytrauma].

Femoral fractures in children are mostly managed conservatively. The recommended methods are overhead traction, 90/90 degree traction on a special table (Weber) and skeletal traction in a Thomas splint or on a Brown's frame. This treatment proves cumbersome in most multiply injured children, especially in those with head injury. Due to uncooperative behaviour the fracture is difficult to hold in an acceptable position. Therefore, operative treatment has been favoured by several authors in the past. Over a period of 8 years, 167 adolescent multiple trauma victims were treated in our institution, 48% of whom had sustained femoral fractures. Since June 1985 such fractures have been stabilized with the unilateral De Bastiani external fixator as the primary and definitive treatment. Our first series consists of ten children (eight male, two female) with a total of eleven fractures, aged 3.2-15 years, mean age 8.1 years. Nine fractures were closed and two compound. Nine fractures were fixed on the day of injury and two 2 days after injury. Depending on the patient's age and the level of the fracture, controlled overriding of 10-15 mm was performed to compensate for expected overgrowth. All fractures healed in an average time of 11 weeks. Free hip and knee movement was achieved in all cases 6 weeks after removal of frame. Neither refracture nor deep infection was seen in any of these patients. Compared with internal fixation, use of this device is less invasive and requires a very short operating time. The fixator can be removed as an outpatient procedure with no need for an anaesthetic.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

External fixation of proximal humerus fracture. Clinical and cadaver study of pinning technique.

The risk of injuring important anatomic structures or interfering with motion of the glenohumeral joint by transcutaneous pinning of the proximal end of the humerus was investigated in 12 cadaver shoulders and in 23 patients with displaced fractures of the proximal humerus. In the cadavers, pinning of the proximal humeral shaft from laterally more than 20 mm below the surgical neck did not injure the neurovascular structures in any case. Pin insertions into the humeral head medial to the intertubercular groove endangered the cephalic vein and interfered with shoulder function by transfixing the subacromial bursa and by restricting internal rotation. Lateral pinning did not carry such risk. In the patients closed reduction and external fixation confirmed the low risk of neurovascular injuries. Lateral pinning of the humeral head resulted in an unrestricted passive mobility of the glenohumeral joint of the anesthetized patient, whereas anterior pinning carried the risk of mechanical restriction of the internal rotation.

Adult↗
PubMed2006

Circular external fixation in knee arthrodesis following septic trauma sequelae: preliminary report.

Deep infection is one of the most devastating complications after knee fractures. It may be related to the initial fracture status or, more commonly, the surgical intervention. From 1991 to 2003, 12 patients underwent knee fusion to treat resistant infection after complex knee fractures or arthrodesis fractures using the Ilizarov method and frame. There were 9 men and 3 women (mean age, 39.7 years). Two-thirds of the patients had long-standing infection and 5 patients had undergone earlier attempts at knee arthrodesis. Correction of concurrent malalignment was achieved in 2 patients. Bone transport using the same arthrodesis frame was necessary in 2 patients to overcome large bony defects. Solid fusion was achieved in all patients by the end of treatment. The average duration of external fixation was 22 weeks (range: 11-44 weeks). No patients required secondary bone grafting to achieve union. Complications occurred in 6 (50%) patients. The most common problem seen was pin tract infection, but only 2 patients required surgical intervention for its treatment. The study emphasizes the clinical success of the Ilizarov method in knee arthrodesis after infected fractures.

Adult↗
PubMed1983

Comparison of mechanical performance in four types of external fixators.

The Hoffmann-Vidal triangular apparatus for fracture fixation of the femur, the Volkov-Oganesian device with Steinmann pins in tension, the Kronner device with a plastic elliptic frame, and the Roger-Anderson apparatus (both standard and compression-distraction designs) were studied based on loading and analytic methods established previously. The results were compared with those for the standard Hoffmann-Vidal quadrilateral configuration. The Kronner device, with five connecting bars, was the stiffest under most loading modes, closely followed by the Hoffmann-Vidal quadrilateral apparatus. The standard Roger-Anderson device demonstrated average rigidity; its new design with compression-distraction capability was relatively weak. All devices showed an apparent weakness in antero-posterior bending. The Volkov-Oganesian design demonstrated low overall stiffness but was the most effective apparatus in resisting anteroposterior bending. External fixators provide effective compression at the fracture site, and the amount of compression is proportional to the stiffness of the apparatus.

Biomechanical Phenomena↗