Dynamic Compared with Static External Fixation of Unstable Fractures of the Distal Part of the Radius

Hove, Leiv M.; Krukhaug, Yngvar; Revheim, Kåre; Helland, Per; Finsen, Vilh

doi:10.2106/jbjs.h.01236

Cited by 26 publications

(7 citation statements)

References 13 publications

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“…54.2%, (2.) 47.3%Dahl classificationPre- and postop IV cephazolin open # IV gentamicin and ornidazole TBSDaily showering and - group 1: brushing the pin sites with soap and a soft toothbrush; group 2: cleaning the crusts using sterile gauze impregnated with 10% polyvinylpyrrolidone iodine (Polyod)1 parenteral AB, two premature fixator removalsChecketts 1995 [28]Dynamic axial fixator.134Adult, tibial shaft #1053.5 monthsRetrospectiveNM39%Minor or majorProphylactic, third-generation cephalosporinNot mentionedRepositioning in 1 patient, removal in 1 patientCheung et al 2008 [8]Hinged external fixators of the elbow100Fractures of the elbow8–94 (31)NMRetrospective25%25%Minor or major75% received a course of postoperative prophylactic oral antibioticsPatients were educated on pin care and were instructed to clean the pin sites with peroxide solution daily.4× early removalDavies et al 2005 [15]External fixation120Fractures or limb reconstructions24–92NMProspectiveNMA, 89.1%; B, 64.9%Episode of pain/inflammation at pin site, + discharge + on bacterial culture or responded to antibioticsNMGroup A: care of the pin site according to local custom; group B: the Russian Ilizarov Scientific Centre technique a Oral AB, removal of the pin or IV AB (numbers not mentioned)Egol et al 2006 [6]External fixation devices118Unstable or displace fractures of the distal radiusAverage 41.3>6 monthsProspective, randomized19%10.1%Requiring oral antibioticsThree doses of IV cephalosporin(1) Weekly dry dressing changes without pin-site care, (2) daily pin-site care with a solution of 1/2 normal saline and 1/2 hydrogen peroxide, (3) placement of a weekly changed chlorhexidine-impregnated disc (Biopatch) around the pinsOral antibiotics 10.1%Hove et al 2010 [29]Dynamic (Dynawrist) and static external fixation (Hoffman II Compact)70Unstable fractures of the distal radiusMean 4212 monthsProspective, randomizedNM43% dynamic 11% static ( p < 0.01)NMNMNMLocal wound cleaning or treatment with antibiotics. No pins removed prematurelyHutson and Zych 1998 [30]Illizarov system135Periarticular fractures of the tibia and fe...…”

Section: Discussionmentioning

confidence: 99%

Complications of transcutaneous metal devices

2011

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A high incidence of associated infection with the use of transcutaneous metal devices has been widely reported. The aims of this study were: (1) to record the incidence of pin site infection in a Plastic Surgery department, (2) to compare the infection rate in our department with published literature and (3) to identify factors that contribute to infection. A prospective cohort study was performed including all patients presenting to the plastic surgery unit with any type of transcutaneous metal in situ over a 3-month period. Patients and staff were questioned on wound hygiene and whether they had been provided with specific protocols. Our study revealed an infection rate of 24%. Patients and staff were not aware of preventive protocols. From this study, the following conclusions are made: (1) pin site infection is a major problem, and no consensus has been reached on the best way to manage pin sites, (2) there is variable knowledge of pin-site care, (3) there is a need for a clearer definition of pin-site infection and a standardised system of assessment, classification and treatment and (4) there is a need for more innovative technology in pin-site manufacture as studies reveal that the type of material used in the pins does affect infection rates.

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Section: Discussionmentioning

confidence: 99%

Complications of transcutaneous metal devices

2011

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“…Other studies have also found good to excellent results with an external fixator allowing wrist mobility (Hayes et al, 6 Hove et al, 4 Gradl et al 7 ) Non-bridging external fixation was found to offer a reliable method of maintaining radiological reduction of unstable distal radius and to give a good functional outcome after 1 year by Anderson et al 12 Our study revealed significant advantage in terms of anatomical restoration and early functional outcome of early dynamization using the modified JESS fixator for displaced unstable comminuted fractures of the distal radius. The JESS fixator consistently restored the palmar tilt of the distal radius, and loss of ulnar tilt and radial height was acceptable.…”

Section: Figure 1: Modified Gartland and Werley Scoring Systemmentioning

confidence: 92%

“…Non-spanning external fixators have the theoretical advantage of allowing wrist mobilization early with the attendant advantages, 4 but often the fixation of pins in small comminuted distal fragments is unsatisfactory. The dynamic external fixators have been developed to provide spanning fixation and at the same time allowing mobilization of the wrist while reduction and fixation are maintained.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Intra-Articular Distal Radius Fractures by a Combined Dynamic and Static Jess Mini External Fixation Technique

Gupta¹,

Chaudhary²,

Khan³

et al. 2014

jemds

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OBJECTIVES:The present study is conducted to evaluate the fracture healing and functional results of combined dynamic with static external fixator for comminuted distal radius fracture. Material and methods: Twenty three adult patients with twenty six comminuted distal radius fractures between age group of 21-67yrs were included. There were five Fry kman type 6, ten Frykman type 7 and eight Frykman type 8 fractures. Closed reduction with ligamentotaxis and percutaneous k-wire fixation was done. Wrist spanning mini external fixator was applied and the kwires supporting the intra-articular reduction were incorporated into the fixator. The fixator was dynamized at 3 weeks by removing the metacarpal pins and cutting short the connecting rod. The dynamized frame was maintained for 3-6weeks. The patients were followed up for 1 year. Gartland and Werley scoring system was used to assess functional outcome. RESULTS: Average time to union was 7.4 weeks. 11 patients (48%) were rated as excellent, 9 (40%) rated as good and 3 (12%) as fair under Gartland and Werley score. CONCLUSION: Our technique of modified JESS fixator did demonstrate good anatomical restoration and early objective functional results.

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“…This increases the pain of sufferers and the curing time is lengthened correspondingly. In some cases, external fixations are used for some weak people, aged people and some people who are seriously suffering from medical disease (Keeling et al, 2008;Hove et al, 2010;Willie et al, 2009). Comparing this to the former method, this method can effectively decrease the time for treatment, but it still has some shortcomings.…”

Section: Introductionmentioning

confidence: 99%

Design and research of a new kind of minimally invasive fixation device in orthopaedics

Xiangdang¹

2011

Afr. J. Biotechnol.

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A new kind of external fixation for orthopaedics was designed in order to overcome the shortcomings of high weight, difficult operation and high degree of injury for the conventional external fixation. This device uses the so called quick casting method, which can be quickly concreted, to efficiently reduce the injury to patients. It is mainly composed of the macromolecule casting material and the steel stainless nails which fasten the device to the bone. In order to verify the feasibility of the designed structure, FEM (finite element method) was used to simulate the real condition of the load when the device was used after an operation. At the same time, optimum design was also carried out for the number and dimension of the nails in order to obtain the best operation effect. It was concluded from the simulated result that when the real load was applied on the fastened broken bone, the relative displacement of the broken border was just 0.33 mm, which was much lesser than the permitted limit (1 mm). This was in line with the request to cure the patients whose bones are broken and it showed the correctness of the design. Finally, in order to prove the feasibility of the design, ten sheep were used as specimen. It was concluded from X-ray sketches of 2, 4 and 8 weeks that there is no relative displacement between the borders of the broken bone and the bone that was well healed. This indicated that this scheme can be feasibly used to cure the broken bones. However, this design scheme can be used as an effective treatment means.

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Dynamic Compared with Static External Fixation of Unstable Fractures of the Distal Part of the Radius

Abstract: Continuous dynamic traction with a dynamic external fixator compares favorably with the use of static external fixators for the treatment of unstable fractures of the distal part of the radius.

Cited by 26 publications

References 13 publications

Complications of transcutaneous metal devices

Complications of transcutaneous metal devices

Treatment of Intra-Articular Distal Radius Fractures by a Combined Dynamic and Static Jess Mini External Fixation Technique

Design and research of a new kind of minimally invasive fixation device in orthopaedics

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