Treatment of open fractures with a computer-assisted external fixator system without the use of fluoroscopy

Abstract

BackgroundDeveloped for the treatment of deformity correction, computer-assisted circular external fixators in recent years have also been used for fracture fixation. In this study, we aimed to present the efficacy of computer-assisted circular external fixator use in open long bone fractures with our new technique.MethodsBetween February 2013 and June 2014, 14 patients (mean age 24.5 (range 20–32)) with open tibial or femoral open fractures were treated with the computer-assisted fixation system (Spider Frame-Tasarım Medikal, Istanbul, Turkey). In all patients, appropriate positions of the rings and Schanz screws were determined by measurements on preoperative radiographs. The length of the Schanz screws were determined by depth measure marks on drill bits. Obvious deformities were corrected intraoperatively by manipulations, but residual deformities were corrected by a software program (Spiderfix, Tasarım Medikal, Istanbul, Turkey). We did not use fluoroscopy during the procedures.ResultsTen patients had tibia diaphyseal and four patients had femoral diaphyseal fractures. Mean surgical time was 24.2 (range 18–28) min. Average follow-up time was 10.2 (range 9–14) months. Mean time for deformity correction was 3.1 (2–5) days. Complete union was observed in all patients with a mean of 4.9 (range 3–9) months. There were two grade 2 pin site infections treated with oral antibiotherapy and pin site care. We did not detect any Schanz screw breakage, loosening, deep infection, nonunion, or malunion.ConclusionsComputer-assisted external fixation systems can be used in the treatment of open fractures, and they provide the chance for acute or gradual correction. Preoperative planning and assistant devices with depth measures may decrease the procedure time and the need for fluoroscopy use.

Deformite cerrahisinin geleceği

“…Ekonomik sıkıntılarını geride bırakmış bir takım ülkelerde acil travma ünitelerinde bilgisayar destekli fiksatörler birincil kırık tespiti için kullanılmaktadır. Basit tübüler fiksatörler kadar hızlı ve sonrasında çerçeve modifikasyonuna izin verecek tespitlerin ilk bilimsel verileri yayımlanmıştır [11] . Otomatize çiviler ise distraksiyon yerine kompresyon yapılarak, kaynama etkinliğinin arttırılması ve daha minimal invaziv cerrahi avantajı sebebi ile travma cerrahisinde kullanılmaya başlanmıştır.…”

Design, analysis and testing of an external fracture fixation device manufactured from composite materials

“…Biocompatible stainless steel bolts are used to anchor the fixator into the bone segments and to maintain them in the desired position. The design of the fixator must be adjustable to the position of the screws and also to appropriate changes in configuration, for example when an adjusting mechanism is used to stimulate the healing process of the bone tissue [9,15].…”