[Use of external fixation equipment for the treatment of obliterative endarteritis of the lower extremities].
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We replaced original Stellbrink-fixator clamps with adjustable horizontal and vertical clamps. Thus, smaller bone fragments can be fixed and there is a possibility to correct their position after application of the fixator. This study compared the primary stability of different constructions by defined flexibility loadings in four-point bending. Statistical evaluation was done by the student-t-test. When used as compression osteosynthesis, the original Stellbrink fixator is the most stable (100%), whereas the modified fixator reaches only 90% of the stability of the original. The better stability of the original Stellbrink fixator only becomes significant when the flexion becomes greater than 13 degrees. Used for distance osteosynthesis, the original Stellbrink fixator is significantly more stable. Clinical examples are presented.
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The introduction of joints in unilateral fixators enables these for multiple deformity corrections. Lengthening and shortening is achieved by changing the length of the fixator telescope. Axial corrections are performed by additive or subtractive techniques using uniplanar joints or by angulation procedures. Translation is done by direct movements of the bone fragments or by metaphyseal "double angulation". Derotation preferably is done as an acute procedure or in the "ring part" of a hybrid frame. Unilateral fixators are used to correct and temporarily stabilize until the correction is held by the intramedullary nail.
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Ilisarov's idea that electrical phenomena could contribute to the efficacy of the ring fixation apparatus prompted us to carry out this preliminary investigation. Patients with lower leg fractures and a four-ring fixation apparatus were selected; the electrical potentials were measured over non-fractured and fractured bones. Patients who could not be studied in the Faraday box were subjected to great disturbances, caused by mains voltage and a neighbouring transmitter; in these cases no objective results could be obtained. Only measurements in the Faraday box yielded reproducible results. The results demonstrate that there is generally a difference in electrical potential among the four rings in patients fitted with an Ilisarov apparatus. Furthermore, weight-bearing on the fixator-bone system causes changes in the electrical potential among the rings.