Structural Stiffness and Reducibility of External Fixators Placed in Malalignment and Malrotation

Carmack, David B.; Kaylor, Kenneth L.; Yaszemski, Michael J.

doi:10.1097/00005131-200105000-00003

Cited by 6 publications

(3 citation statements)

References 18 publications

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“…3,7,11,16,20,23 Bosse et al 3 evaluated biomechanical data and ease of applicability of two simple external fixators (Howmedica Ultra-X and Synthes Trauma-Fix). For biomechanical testing, they compared standard commercial external fixators with those designed for the military.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Two Military Temporary Femoral External Fixators

Dougherty¹,

Vickaryous²,

Conley³

et al. 2003

Clinical Orthopaedics &Amp; Related Research

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Temporary external fixation of femur fractures, used at civilian trauma centers for patients who cannot tolerate more extensive procedures, also is planned for use in military field hospitals to provide temporary stabilization and allow for safe transport of a patient to the next level of care. The purpose of the current study was to evaluate three constructs: an external fixator made by one manufacturer and two Hoffman II constructs: uniplanar and biplanar. The study consisted of two parts: a biomechanical study of each of the three constructs and the application of each of the two Hoffmann II constructs to separate cadaver thighs by resident surgeons. Five resident surgeons participated in the study using five pairs of cadaver thighs. The biplanar construct was stiffer in axial and torsional stability when compared with the uniplanar construct. There was no difference in the amount of time needed to apply the constructs nor was either construct found to be subjectively easier to apply by the surgeons. There was an increased number of unicortical pins and plunges (when a pin inadvertently slips over the side) with the uniplanar construct when compared with the biplanar. The biplanar construct is biomechanically more stable and appears to allow for more accurate placement of pins.

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Section: Discussionmentioning

confidence: 99%

A Comparison of Two Military Temporary Femoral External Fixators

Dougherty¹,

Vickaryous²,

Conley³

et al. 2003

Clinical Orthopaedics &Amp; Related Research

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“…Instability was probably the most important contributing factor besides multiple pin entrances. It is well documented that external fixation using appropriate equipment is probably the most efficient way for primary stabilization when the surgeon is confronted with a large number of severe limb injuries under combat conditions [5][6][7][8][9], and we should strive to use the most mechanically sound and clinically proven fixation systems available, especially under difficult conditions with a limited number of treatment alternatives.…”

Section: Early Failure Of External Fixationmentioning

confidence: 99%

Letters for J R Army Med Corps 2008; vol 154

2008

J R Army Med Corps

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“…Achieving this ideal, however, is often hindered by factors such as loss of bone mass, infection and partialthickness skin or wound necrosis, which makes surgical treatment difficult or results in failure [2,5] and can contribute to a less than optimal reconstruction that may predispose the ankle joint to the development of post-traumatic arthrosis, nonunion, malunion or pseudarthrosis. Although, historically, various types of treatment have been developed for type C pilon fractures [6,9,11], there is no consensus regarding operative or nonoperative treatment because results have been less than optimal. For example, the issue of localised devitalisation of bone and further damage to surrounding soft tissue may occur after internal fixation.…”

Section: Introductionmentioning

confidence: 99%

Two-stage procedure protocol for minimally invasive plate osteosynthesis technique in the treatment of the complex pilon fracture

Tong

Zhang

et al. 2011

International Orthopaedics (SICOT)

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Purpose Here we introduce a two-stage procedure protocol for minimally invasive plate osteosynthesis (MIPO) to treat complex pilon fractures and evaluate surgical wound healing and infection rates after this method was applied in clinical practice. Method This is a retrospective study design. The protocol consisted of immediate (within eight to 24 hours) open reduction and internal fixation of the fibula, using a fibular plate or one third tubular plate and application of an external fixator spanning the ankle joint. Patients were discharged after initial stabilisation and revaluated approximately ten to 14 days after discharge. Formal open reconstruction of the articular surface using MIPO depended on whether soft tissue swelling had lessened. Artificial bone was then injected into the defect rather than open surgery. Objective evaluation criteria were wound infection rates. Objective criteria (amount of post-traumatic arthritis, range of ankle movement, number of arthrodeses) and subjective criteria (pain, swelling, restriction of work or leisure activities) were identified via chart and radiograph reviews, patient interviews and physical examination. Results Twenty-nine patients, each with one pilon fracture were included. First-stage operations were performed from eight hours to seven days after injury, depending on whether the fracture was open or not. Average time from external fixation to open reduction and revision was one month (range 24-38 days); average time for the second-stage operation was 58 (range 45-110) minutes; average amount of haemorrhage was 400 (range 150-560) ml; average time of follow-up was 24 months and average time of healing was 6.7 (range five to 11.5) months after the second stage. There was no superficial or deep infection or wound-healing problem. All patients had normal functioning ankle joints. Conclusion Application of the two-stage procedure protocol with MIPO seems to play a key role in reducing infection rates associated with open reduction and internal fixation of pilon fractures. Its effectiveness in closed and open fractures will be further tested by a late randomised controlled study.

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Structural Stiffness and Reducibility of External Fixators Placed in Malalignment and Malrotation

Cited by 6 publications

References 18 publications

A Comparison of Two Military Temporary Femoral External Fixators

A Comparison of Two Military Temporary Femoral External Fixators

Letters for J R Army Med Corps 2008; vol 154

Two-stage procedure protocol for minimally invasive plate osteosynthesis technique in the treatment of the complex pilon fracture

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