Abstract
Purpose
This study aimed to investigate the biomechanical properties of a novel semicircular
locking external fixator with locking screw mechanism, shape of trapezoidal corrugations,
half- ring designed for greater stability.
Materials and methods
The novel external fixator had a half-ring with the shape of trapezoidal corrugations
and locking screws fixing the bone at different angles in all three planes (sagittal,
axial, and coronal). The biomechanical properties of the semicircular locking external
fixator (group 1) were compared with those of a standard Ilizarov-type circular external
fixator (group 2) (TST, İstanbul, Turkey) in an experimental study design. Five frames
were used in each group. Standard PE 1000 (polyethylene) rod models (n = 10) simulating the tibia bone model were used. Both systems were compared biomechanically
by applying axial and torsional loads simultaneously.
Result
Two samples in group 2 were damaged before the test ended during axial loading. All
of the samples in group 1 completed the tests without damage after 150,000 cycles.
The axial stiffness of the semicircular locking external fixator was found to be significantly
higher than that of the Ilizarov-type circular external fixator (p < 0.05). No statistically significant difference was found between the two fixators
in torsional loading. The application time of semicircular locking external fixator
was significantly shorter than Ilizarov-type circular external fixator (p < 0.05).
Conclusion
The novel semicircular locking external fixator was biomechanically stronger than
the Ilizarov-type external fixator for treating fractures of long bones. It can be
used as a permanent external fixator for the definitive treatment of long bone fractures
with soft tissue damage in terms of stability and application time.
Keywords
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References
- Injuries in developing countries–how can we help? The role of orthopaedic surgeons.Clin Orthop Relat Res. 2008; 466: 2443-2450https://doi.org/10.1007/s11999-008-0387-0
- Understanding and addressing the global need for orthopaedic trauma care.J Bone Joint Surg Am. 2016; 98: 1844-1853https://doi.org/10.2106/JBJS.16.00323
- Conversion from temporary external fixation to definitive fixation: shaft fractures.J Am Acad Orthop Surg. 2006; 14: 124-127https://doi.org/10.5435/00124635-200600001-00028
- External fixation and temporary stabilization of femoral and tibial trauma.J Surg Orthop Adv. 2011; 20: 74-81
- Cost variation in temporizing external fixation of tibial plateau fractures.J Orthop Trauma. 2019; 33: S5-S10https://doi.org/10.1097/BOT.0000000000001620
- Wide variation of surgical cost in the treatment of periarticular lower extremity injuries between 6 fellowship-trained trauma surgeons.J Orthop Trauma. 2016; 30: e377-ee83https://doi.org/10.1097/BOT.0000000000000687
- Analysis of usage and associated cost of external fixators at an urban level 1 trauma centre.Injury. 2014; 45: 1611-1613https://doi.org/10.1016/j.injury.2014.04.031
- Economics of open tibial fractures: the pivotal role of length-of-stay and infection.Health Econ Rev. 2017 Sep 25; 7: 32https://doi.org/10.1186/s13561-017-0168-0
- Experience with a large-frame, disposable external fixator.Orthopedics. 2010; 33
- Use of reprocessed external fixators in orthopaedic surgery: a survey of 243 orthopaedic trauma surgeons.Patient Saf Surg. 2018; 12 (Published 2018 Jun 7)https://doi.org/10.1186/s13037-018-0156-2
- Aparatus, components and biomechanical principal of application transosseous osteosynthesis.1992: 63-136 (Germany)
- Mechanical performance of Ilizarov circular external fixators in comparison with other external fixators.Clin Orthop Relat Res. 1993; : 61-70
- Mechanical considerations in using tensioned wires in a transosseous external fixation system.Clin Orthop Relat Res. 1992; : 23-29
- The use of Wires and Pins.Tech. Orthop. 1990; : 19-25
- The tension-stress effect on the genesis and growth of tissues. Part I. The influence of stability of fixation and soft-tissue preservation.Clin Orthop Relat Res. 1989; : 249-281
- Efficacy of a compliant semicircular Ilizarov pin fixator module for treating infected nonunion of the femoral diaphysis.Strategies Trauma Limb Reconstr. 2014; 9: 101-109https://doi.org/10.1007/s11751-014-0199-6
- Stiffness characteristics of the circular Ilizarov device as opposed to conventional external fixators.J Biomech Eng. 1990; 112: 15-21https://doi.org/10.1115/1.2891120
- Chapman Michael W The technique of circular eksternal fixation. Operative orthopeadics. JB Lippincott Company, Philadelphia1993: 949-964 (Chapter 63)
- Ring size selection Tech.Orthop. 1990; : 13-18
- Basic principles of transosseous compression and distraction osteosynthesis.Orthop Travmatol Protez. 1971; 32: 7-15
- Efficacy of a compliant semicircular Ilizarov pin fixator module for treating infected nonunion of the femoral diaphysis.Strategies Trauma Limb Reconstr. 2014; 9: 101-109https://doi.org/10.1007/s11751-014-0199-6
- Circular external fixation frames with divergent half pins: a pilot biomechanical study.Clin Orthop Relat Res. 2008; 466: 2933-2939https://doi.org/10.1007/s11999-008-0492-0
- A review of locking compression plate biomechanics and their advantages as internal fixators in fracture healing.Clin Biomech (Bristol, Avon). 2007; 22: 1049-1062https://doi.org/10.1016/j.clinbiomech.2007.08.004
- Early mechanical failures of the synthes variable angle locking distal femur plate.J Orthop Trauma. 2016; 30: e7-e11https://doi.org/10.1097/BOT.0000000000000391
- Technical difficulties of removal of locking screw after locking compression plating.Arch Orthop Trauma Surg. 2009; 129: 91-95https://doi.org/10.1007/s00402-008-0769-5
- A locking compression plate as an external fixator for treating infected nonunion of the humeral diaphysis.BMC Surg. 2016; 16: 53https://doi.org/10.1186/s12893-016-0167-9
- One-stage external fixation using a locking plate: experience in 116 tibial fractures.Orthopedics. 2015; 38: 494-497https://doi.org/10.3928/01477447-20150804-05
- Staged treatment of proximal tibial fracture using external locking compression plate.Orthop Surg. 2014; 6: 154-157https://doi.org/10.1111/os.12101
Article info
Publication history
Published online: January 09, 2022
Accepted:
December 30,
2021
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
