Background: AO type C3 distal radius fracture (DRF) is the most difficult-to-treat fracture type because of a tendency to shorten and collapse. The purpose of this study is to investigate the clinical and radiographic...Background: AO type C3 distal radius fracture (DRF) is the most difficult-to-treat fracture type because of a tendency to shorten and collapse. The purpose of this study is to investigate the clinical and radiographic outcomes of comminuted intra-articular DRFs treated with a dynamic external fixator combined with a volar locking plate (VLP). Methods: Eleven patients (mean age, 61 years) with comminuted intra-articular DRFs were treated with a dynamic type of external fixator combined with a VLP. Following reduction and fixation with a VLP, the dynamic external fixator was applied and the distal ball joint of the fixator was aligned with the lunate-capitate line. The ball joint was unlocked approximately 2 weeks after surgery to allow wrist mobilization. The fixator was removed 3 - 6 weeks (mean, 5 weeks) after surgery. Consequently, clinical and radiographic assessments were carried out at the final follow-up. Results: At the final follow-up, the mean range values of wrist extension and flexion were 76°and 64°, respectively. Compared with the contralateral side, the mean grip strength was 84%. The mean Modified Mayo Wrist Score and the Disabilities of the Arm, Shoulder and Hand score were 88 and 9, respectively. No significant differences in the radiographic parameters exist between after surgery and final follow-up. Conclusions: This study indicated that the dynamic wrist fixator combined with a VLP is effective for the treatment of AO type C3 DRFs.展开更多
BACKGROUND Reconstruction of the pelvic ring anatomy in unstable anterior pelvic ring injuries is a significant step to reduce the mortality rate associated with these injuries efficiently.There is a debate on using e...BACKGROUND Reconstruction of the pelvic ring anatomy in unstable anterior pelvic ring injuries is a significant step to reduce the mortality rate associated with these injuries efficiently.There is a debate on using either an anterior subcutaneous pelvis internal fixator(INFIX)or an anterior supra-acetabular external fixator(EXFIX)to manage an unstable anterior pelvic ring fracture.AIM To compare the functional and radiological outcomes and complications of INFIX vs EXFIX in managing unstable pelvic ring injuries.METHODS A prospective cohort study included 54 patients with unstable pelvic ring fractures.The patients were divided into two groups;the INFIX group,in which 30 cases were fixed by INFIX,and the EXFIX group,in which 24 patients were treated by EXFIX.The average age in the EXFIX group was 31.17 years(16-57 years),while in the INFIX group,it was 34.5 years(17-53 years).The study included 20(66.7%)males and 10(33.3%)females in the INFIX group and 10(41.7%)males and 14(58.3%)females in the EXFIX group.The radiological outcomes were evaluated using Matta and Tornetta's score,and the functional outcomes using the Majeed score.RESULTS The results revealed a statistically significant difference between both groups(P=0.013)regarding radiological outcomes,according to Matta and Tornetta's score in favor of the INFIX group.Sitting,standing,and walking abilities were measured at a 3-mo follow-up visit using Majeed score modules.It was significantly better among the INFIX group than the EXFIX group in all three modules.At the final follow-up,both groups had no statistically significant difference according to the Majeed score;92.35 in the INFIX group and 90.99 in the EXFIX group(P=0.513).A lower surgical site infection rate was noticed in the INFIX group(P=0.007).CONCLUSION Anterior subcutaneous pelvis INFIX is associated with better radiological outcomes and a lower infection rate than anterior supra-acetabular EXFIX in managing patients with unstable anterior pelvic ring fractures.展开更多
A stress analysis of the Sarafix external fixator design was performed using finite element analysis （FEA） and experimental tensometric measurements. The study was conducted at one of the Sarafix fixator configurati...A stress analysis of the Sarafix external fixator design was performed using finite element analysis （FEA） and experimental tensometric measurements. The study was conducted at one of the Sarafix fixator configurations that have a clinical application in the treatment of tibia fractures. The intensity of principal and yon Mises stresses generated at two measuring points （MP） on the fixator connecting rod were monitored and analyzed during the testing on axial compression on the fixator design and its finite element model （FEM）. The 3D geometrical and FEM model of the fixator was formed using the computer aided design/computer aided engineering （CAD/CAE） software system CATIA. Verification of the results for the dominant principal stresses obtained from FEA was carried out through tensometric measurements. The measuring chain consisted of strain gauges connected into two Wheatstone half-bridges, digital measuring amplifier system and a computer with software for acquisition and monitoring of measurement results. A quite good agreement was observed between the results obtained on the basis of FEA and results of experimental tensometric analysis,展开更多
Objective To evaluate effects of manipulative reduction,dynamic external fixator combined with limited internal fixation for the treatment of Pilon fractures.Methods From January 2007 to June 2009,manipulative reducti...Objective To evaluate effects of manipulative reduction,dynamic external fixator combined with limited internal fixation for the treatment of Pilon fractures.Methods From January 2007 to June 2009,manipulative reduction,dynamic external展开更多
Objective To evaluate the clinical effects of Ilizarov external fixator for maluninon of obsolete calcaneal fracture of Stephen Type Ⅲ.Methods From July 2006 to February 2009,25 patients suffering from maluninon of o...Objective To evaluate the clinical effects of Ilizarov external fixator for maluninon of obsolete calcaneal fracture of Stephen Type Ⅲ.Methods From July 2006 to February 2009,25 patients suffering from maluninon of obsolete calcaneal展开更多
The Ortho-SUV frame,a novel external fixator,can effectively treat limb deformities and fractures.Its kinematics is used when it is necessary to achieve bone movements with high precision.In this work,the kinematics m...The Ortho-SUV frame,a novel external fixator,can effectively treat limb deformities and fractures.Its kinematics is used when it is necessary to achieve bone movements with high precision.In this work,the kinematics model of the Ortho-SUV frame is established by six pose parameters,and its forward and inverse solutions are given.There is no need to solve nonlinear high-coupling equations with trigonometric functions in this solution method due to its special structure.By numerical examples and simulated orthopedic experiment of tibial fracture,the correctness and accuracy of the kinematics model and its solutions are verified.Besides,on the basis of kinematics analysis,the position workspace and orientation workspace of the Ortho-SUV frame are simulated in Matlab,which can help surgeons choose suitable device dimensions.The kinematics analysis provides a theoretical basis for the Ortho-SUV frame to be used in orthopedic treatment.展开更多
Introduction: The Hybrid External Fixator combines the advantages of the monolateral pin fixators and the circular Ilizarov wire fixators. Principle of early motion has been touted as the functional savior of major in...Introduction: The Hybrid External Fixator combines the advantages of the monolateral pin fixators and the circular Ilizarov wire fixators. Principle of early motion has been touted as the functional savior of major intra articular injuries in application of hybrid external fixation. Materials & Methodology: 48 patients were considered for the study with tibial fractures admitted in Mamata General Hospital from May 2011 to May 2013. Results: The union and functional outcome of hybrid external fixator in simple and complex proximal and distal metaphyseal fractures of tibia in adults was evaluated at our centre. The fractures of the proximal tibia united with an average of 13.3 weeks (12 - 16 weeks). The fractures of the distal tibia united with an average of 14.42 weeks (13 - 22 weeks) with minimal complications. Conclusion: Our study shows high satisfaction rate after fixation, provides adequate stability and allows early motion of the joint. It is also effective in extra articular fractures occurring within 5 cm of the joint as the IM nails often do not provide enough stability and plating requires extensive soft tissue dissection.展开更多
The objective of the present study was to investigate our novel methods for the repair of massive cartilage defects by joint distraction and motion using an external fixator. In this study, we used a rabbit model of m...The objective of the present study was to investigate our novel methods for the repair of massive cartilage defects by joint distraction and motion using an external fixator. In this study, we used a rabbit model of massive articular cartilage defect in order to evaluate the effectiveness of using joint distraction and motion with a ring-type external fixator. This external fixator has a hinged joint with a center of rotation along the femoral transepicondylar axis, which allows the knee joint to freely flex and extend. Mesenchymal cells from bone marrow, induced by spongialization, were differentiated into mature chondrocytes and formed hyaline-like cartilage as a result of joint distraction and movement. The transplantation of autologous cells expanded from bone-marrow-derived mesenchymal cells, concentrated autologous bone marrow aspirate, and concentrated autologous peripheral blood cells were all effective in promoting cartilage repair. The quality of the cartilage after long-term joint distraction for 6 months was inferior to that after 12 weeks. In general, weight bearing on the regenerated cartilage promoted cartilage repair, although this effect differed based on when gradual weight bearing was begun. Specifically, gradual weight bearing beginning at 9 weeks produced superior results to that beginning at 6 weeks. Our methods provide an optimal environment for cartilage regeneration.展开更多
BACKGROUND High tibial osteotomy(HTO)is a well-known procedure for the correction of knee varus.The purpose of this study was to compare the radiological results and accuracy of deformity correction performed using tw...BACKGROUND High tibial osteotomy(HTO)is a well-known procedure for the correction of knee varus.The purpose of this study was to compare the radiological results and accuracy of deformity correction performed using two different techniques:acute opening wedge correction using a plate and gradual correction with a monolateral external fixator.AIM To compare of the radiological results of two different techniques:acute opening wedge correction(a plate and screw)and gradual correction(external fixator).METHODS A total of 43 patients with plates and 36 patients with external fixators were included.All patients had moderate uniplanar varus deformities.We measured radiographic parameters,including the mechanical axis deviation(MAD),medial proximal tibial angle(MPTA),Caton-Deschamps Index(CDI),posterior proximal tibial angle,and joint line obliquity angle(JLOA).The accuracy of MAD correction was calculated based on a correction goal of neutral or overcorrection for medial compartment arthritis.RESULTS Demographics including age,body mass index,sex,and preoperative deformities were similar between the groups.The MAD significantly improved from 23.6 mm medial to the midline(SD=8.2 mm)to 6.9 mm lateral to the midline(SD=5.4 mm)(P<0.001).The accuracy of MAD correction did not differ between the groups and was 96.1%(SD=8.1%)in the plate group and 98.2%(SD=5.2%)in the external fixator group(P=0.18).The MPTA significantly improved from 83.9°(SD=2.9°)to 90.9°(SD=3.3°)(P<0.001),and the change was similar between the groups.Differences were noted in patella height,with a CDI change of-19.2%(SD=13.7%)and 3.1%(SD=8.0%)for the plate and external fixator groups,respectively(P<0.001).The change in JLOA was 1.6 degrees(SD=1.1 degrees)and 0.9 degrees(SD=0.9 degrees)for the plate and external fixator groups,respectively(P=0.04).CONCLUSION Reliable correction of moderate varus alignment was achieved with both the acute opening wedge technique with a plate and the gradual monolateral external fixator technique.The patellar height decreased with the open wedge plate technique.Joint line obliquity decreased to a greater degree with the open wedge plate technique,perhaps as a result of medial collateral ligament release.The appropriate technique should be selected based on surgeon and patient preferences;however,external fixation may be a better choice when the preservation of patellar height is deemed important.展开更多
Objective: Unicameral bone cyst is a nonneoplasticbone lesion characterized by its tenacity and risk ofrecurrence. Pathological fracture is common and is often the presenting symptom. The objective of the present stud...Objective: Unicameral bone cyst is a nonneoplasticbone lesion characterized by its tenacity and risk ofrecurrence. Pathological fracture is common and is often the presenting symptom. The objective of the present study was to evaluate the results of hybrid external fixator for thetreatment of a unicameral bone cyst with a pathologicalfracture. Methods: Hybrid external fixator for thetreatment of a unicameral bone cyst was performed intwelve patients. These patients presented with a pathological fracture and were managed immediately with hybridexternal fixator, of whom four had been managedconservatively at other clinics before they were referred toour department. The cyst was located in the proximalhumerus in all patients. The mean age of the patients at the time of surgery was 8.7 years, and the mean duration offollow-up was 32.6 months. Radiographic evaluation wasperformed according to the criteria of Capanna et al., andthe cyst was classified as completely healed, healed withresidual radiolucency (osteolysis), recurred, or having noresponse. Results: The healing period ranged from three to eight months. Eight cysts healed completely, and threehealed with residual radiolucent areas visible onradiographs. There was recurrence of one cyst that hadhealed with residual radiolucency. All of the cysts in thepresent study responded to treatment. A modulation ofhybrid external fixator was necessary in three patients, asthe bars had become too short after bone growth or the pins had been loose. No major complications were observed.Conclusion: Hybrid external fixator provides earlystability, which allows early mobilization and thus obviates the need for a plaster cast. This method of treatment alsoallows for an early return to normal activity.展开更多
Four tibiae removed from 30-40 years males, who died of accidents in less than 12 hours, were os- teomized at medium part. Then these tibiae were fixed by an unilateral hooked-sulcated external fixator (UHSEF), and th...Four tibiae removed from 30-40 years males, who died of accidents in less than 12 hours, were os- teomized at medium part. Then these tibiae were fixed by an unilateral hooked-sulcated external fixator (UHSEF), and the bone-fixator system was used as a model of external fixation of tibial fracture. The axial compression, distraction, torsion, antero-posterior and lateral bending rigidly and the strain of the pins were determined in this system. Based on the results, we found that compared with the configuration of four paralled pins, the rigidity of the fan-like configuraton didn’t decrease significantly if the angle between lateral and medium pins was less than 45’. But the reverse was true when the frame separation increased from 5 to 8 cm. What’ more, the pin strain decreased if the rigidity of the system was improved. These data provided a theoretical basis of biomechanics for the improvement of UHSEF.展开更多
After the first research with this technique done by the first author, ten operations on the foot and ankle were performed on five patients (two boys and three girls) suffering from severe club foot deformity all with...After the first research with this technique done by the first author, ten operations on the foot and ankle were performed on five patients (two boys and three girls) suffering from severe club foot deformity all with bilateral foot affection. Their ages ranged from five to fourteen years. All of them were treated by soft tissue release, skin flap (rotational flap), supplemented with Alkhooly external fixator. The follow up period ranged from two to seven years. The results according to Mittal (1987) [1] were excellent in eight feet (80%) and good in two feet (20%).展开更多
Objective: to explore the clinical nursing strategy of pelvic fracture patients after external fixator treatment. Methods: 82 patients with pelvic fracture admitted to our hospital from June 2019 to December 2020 were...Objective: to explore the clinical nursing strategy of pelvic fracture patients after external fixator treatment. Methods: 82 patients with pelvic fracture admitted to our hospital from June 2019 to December 2020 were selected as the research objects and randomly divided into nursing group and control group. Among them, the patients in the control group were given routine nursing interventions in our hospital, and the patients in the nursing group were given comprehensive nursing interventions on this basis, and then the clinical nursing effects of the two groups were compared and analyzed. Results: the incidence of complications in nursing group was 2.44%, which was significantly lower than that in control group (21.95%). The average hospitalization time of patients in the control group was (20.7±3.5) days, which was significantly longer than that in the nursing group (14.5±2.2) days, with significant difference between the two groups (P<0.05). Conclusion: during the clinical treatment of patients with pelvic fracture, if comprehensive clinical nursing intervention measures can be taken on the basis of conventional external fixator treatment and nursing, the rehabilitation of patients can be accelerated, the hospitalization time of patients can be shortened, and the incidence of complications can be reduced.展开更多
Objective: to explore the clinical value of external fixator in traumatic orthopedic cases. Methods: 86 cases of traumatic orthopedic diseases treated in our hospital from April 2020 to April 2021 were randomly divide...Objective: to explore the clinical value of external fixator in traumatic orthopedic cases. Methods: 86 cases of traumatic orthopedic diseases treated in our hospital from April 2020 to April 2021 were randomly divided into 43 cases in the observation group and 43 cases in the control group. In terms of treatment methods, the control group was treated with internal fixation, while the observation group was treated with external fixation. The rehabilitation treatment effects of the two groups were compared. Results: through surgical treatment, in the comparison of various index data, the treatment effect of the observation group was more effective than that of the control group. Conclusion: for the treatment of traumatic orthopedic diseases, the technical treatment with external fixator can promote the significant improvement of fracture and reduce the incidence of complications, which is worthy of popularization in clinic.展开更多
Objective: To evaluate the effectiveness of the damage control, in emergency to treat the open tibial pilon fractures with Dolphix? External Fixator Frame(CITIEFFE?, Calderara di Reno, Bologna, Italy). Methods: From J...Objective: To evaluate the effectiveness of the damage control, in emergency to treat the open tibial pilon fractures with Dolphix? External Fixator Frame(CITIEFFE?, Calderara di Reno, Bologna, Italy). Methods: From January 2017 to August 2017, at the Department of Orthopedics and Traumatology of Vito Fazzi Hospital Lecce, we treated 23 open tibial pilon fractures with Dolphix? External Fixator Frame(CITIEFFE?, Calderara di Reno, Bologna, Italy). The evaluation criteria of the case series were: the time needed to assemble the external fixator;the time taked to treat the ankle associated lesions;the time of skin healing;the ankle alignment;the subjective/objective Ovadia and Beals score;and complications. The Endpoint assessment was set at the days of the definitive surgery. Results: The results in terms of alignment, biomechanical stability of the frame, healing of soft tissue, complications were as good as the objective and subjective results according Ovadia and Beals score. Conclusion:Pilon fractures are complex and often present complications;the damage control treatment, in emergency, with Dolphix? External Fixator Frame(CITIEFFE?, Calderara di Reno, Bologna, Italy) permits a stable osteotaxis with minimal soft tissue damage and permit the repair of muscles, blood vessels and nerves with a stable bone and the soft tissue healing with vaccum therapy.展开更多
Objective:To understand the current awareness and willingness to learn about the use of out-of-hospital automated external defibrillators(AEDs)in Deyang City,providing a basis for improving the success rate of rescue ...Objective:To understand the current awareness and willingness to learn about the use of out-of-hospital automated external defibrillators(AEDs)in Deyang City,providing a basis for improving the success rate of rescue operations.Methods:A questionnaire survey was conducted among residents in Deyang City from January 2025 to October 2025,covering residents’basic information,awareness of AED-related knowledge,and attitudes towards AED usage.Results:A total of 1,886 questionnaires were collected,with 1,823 valid questionnaires,yielding an effective rate of 96.66%.Among the 1,823 respondents,692(37.96%)had received cardiopulmonary resuscitation(CPR)-related learning or training,619(33.96%)could accurately describe the name of an AED,417(22.87%)could clearly describe the function of an AED,and 308(16.89%)could accurately describe how to use an AED.Among them,1,549(84.97%)were willing to provide assistance to patients experiencing cardiac arrest;1,731(94.95%)were willing to provide assistance under the premise of knowing how to use an AED;and 1,750(95.99%)were willing to learn about AED-related knowledge.Among the 91 individuals unwilling to provide rescue,75 responded with reasons.Among them,36 cases(48.00%)were reluctant to rescue due to a lack of relevant first aid knowledge,32 cases(42.67%)expressed concerns about exacerbating the patient’s condition due to improper operation,and 4 cases(5.33%)were unwilling to interact with strangers due to personal reasons.Conclusion:Currently,residents in Deyang City have limited knowledge about AEDs but demonstrate a strong willingness to learn and apply them.Measures need to be taken to enhance their understanding and application of AEDs.展开更多
Fuel-coolant interaction(FCI)remains one of the most complex challenges in severe accident research,with the triggering process being a key aspect that may govern subsequent fine fragmentation and potential steam expl...Fuel-coolant interaction(FCI)remains one of the most complex challenges in severe accident research,with the triggering process being a key aspect that may govern subsequent fine fragmentation and potential steam explosions.In this study,the evolution characteristics of droplet-water interactions under external disturbance conditions were investigated using a self-designed FCI experimental setup.The experimental observations revealed that cavity formation reduced the drag force on the droplet,thereby increasing its peak velocity.However,the external disturbance pressure can disrupt the cavity,leading to a reduction in the droplet peak velocity.Furthermore,it was found that an increase in external disturbance pressure tended to increase the peak value of the droplet expansion rate,thereby promoting the fine-fragmentation process.This effect holds regardless of the initial droplet temperature,coolant temperature,or even when using droplet materials such as lead,which is generally considered unfavorable for steam explosions.Comparative analyses indicated that a higher external disturbance pressure may shorten the triggering time of the droplet surface and enhance the trigger intensity.These findings provide important phenomenological insights for further investigation of the triggering mechanisms in the initial stage of fuel-coolant interactions.展开更多
The effects of the high pressure die casting(HPDC)processes on porosity,microstructure,and mechanical properties of heat-treatment-free aluminum silicon(Al-Si)alloys have long been a focal point in automotive die-cast...The effects of the high pressure die casting(HPDC)processes on porosity,microstructure,and mechanical properties of heat-treatment-free aluminum silicon(Al-Si)alloys have long been a focal point in automotive die-casting research.In this work,the combined effect of shot sleeve materials and slow shot speeds on porosity,microstructure and mechanical properties of a newly designed HPDC Al-Si alloy was investigated.Results show that employing a ceramic shot sleeve or increasing the slow shot speed significantly reduces both the average size and area fraction of externally solidified crystals(ESCs),as well as the average pore size and volume fraction.When the slow shot speed is increased from 0.05 m·s^(-1)to 0.1 m·s^(-1),the pore volume fraction decreases by 10.2%in steel-shot-sleeve samples,compared to a substantial 67.1%reduction in ceramic-shot-sleeve samples.At a slow shot speed of 0.1 m·s^(-1),castings produced with a ceramic shot sleeve exhibit superior mechanical properties:8.3%higher yield strength,17.4%greater tensile strength,and an 81.4%improvement in elongation,relative to those from a steel shot sleeve.These findings provide valuable insights for minimizing porosity and coarse ESCs in die castings,offering promising potential for broader industrial applications.展开更多
Basic life support for cardiac arrest associates cardiopulmonary resuscitation(CPR)and defibrillation.CPR relies on chest compressions(CC)and ventilation.Current guidelines on CPR recommend a depth of 5-6 cm at a rhyt...Basic life support for cardiac arrest associates cardiopulmonary resuscitation(CPR)and defibrillation.CPR relies on chest compressions(CC)and ventilation.Current guidelines on CPR recommend a depth of 5-6 cm at a rhythm of 100-120 times/min for CC.[1,2]Interruptions of the CC must be as short as possible and are related to ventilation,defibrillation and turnover of the rescuers.Most of the automated external defibrillators(AEDs)require interruptions of the CC to perform rhythm analysis.Among the numerous marketed models of AEDs,some provide real-time feedback about the quality of the CC.展开更多
Five fresh tibias removed from 30-40 years old dead males were osteotomized at one-third supra-medium segment and then fixed by an unilateral adjustable external fixator (UAEF) to be used as a model of external fixati...Five fresh tibias removed from 30-40 years old dead males were osteotomized at one-third supra-medium segment and then fixed by an unilateral adjustable external fixator (UAEF) to be used as a model of external fixation of tibial fracture. For each loading test under different configurations of UAEF, the ratio of the force-displacement was used to determine its stiffness value. The weakest mode of the UAEF device is in AP bending. Under each mode of compression,distraction , anteroposterial and lateral bending and torsion loading , increasing the pin number or pin diameter or pin separation, and/or reduction of pin group separation can significantly increase the stiffness values of UAEF (P<0.01). These data revealed that UAEF is suitable for the external fixation of tibial fracture.展开更多
文摘Background: AO type C3 distal radius fracture (DRF) is the most difficult-to-treat fracture type because of a tendency to shorten and collapse. The purpose of this study is to investigate the clinical and radiographic outcomes of comminuted intra-articular DRFs treated with a dynamic external fixator combined with a volar locking plate (VLP). Methods: Eleven patients (mean age, 61 years) with comminuted intra-articular DRFs were treated with a dynamic type of external fixator combined with a VLP. Following reduction and fixation with a VLP, the dynamic external fixator was applied and the distal ball joint of the fixator was aligned with the lunate-capitate line. The ball joint was unlocked approximately 2 weeks after surgery to allow wrist mobilization. The fixator was removed 3 - 6 weeks (mean, 5 weeks) after surgery. Consequently, clinical and radiographic assessments were carried out at the final follow-up. Results: At the final follow-up, the mean range values of wrist extension and flexion were 76°and 64°, respectively. Compared with the contralateral side, the mean grip strength was 84%. The mean Modified Mayo Wrist Score and the Disabilities of the Arm, Shoulder and Hand score were 88 and 9, respectively. No significant differences in the radiographic parameters exist between after surgery and final follow-up. Conclusions: This study indicated that the dynamic wrist fixator combined with a VLP is effective for the treatment of AO type C3 DRFs.
文摘BACKGROUND Reconstruction of the pelvic ring anatomy in unstable anterior pelvic ring injuries is a significant step to reduce the mortality rate associated with these injuries efficiently.There is a debate on using either an anterior subcutaneous pelvis internal fixator(INFIX)or an anterior supra-acetabular external fixator(EXFIX)to manage an unstable anterior pelvic ring fracture.AIM To compare the functional and radiological outcomes and complications of INFIX vs EXFIX in managing unstable pelvic ring injuries.METHODS A prospective cohort study included 54 patients with unstable pelvic ring fractures.The patients were divided into two groups;the INFIX group,in which 30 cases were fixed by INFIX,and the EXFIX group,in which 24 patients were treated by EXFIX.The average age in the EXFIX group was 31.17 years(16-57 years),while in the INFIX group,it was 34.5 years(17-53 years).The study included 20(66.7%)males and 10(33.3%)females in the INFIX group and 10(41.7%)males and 14(58.3%)females in the EXFIX group.The radiological outcomes were evaluated using Matta and Tornetta's score,and the functional outcomes using the Majeed score.RESULTS The results revealed a statistically significant difference between both groups(P=0.013)regarding radiological outcomes,according to Matta and Tornetta's score in favor of the INFIX group.Sitting,standing,and walking abilities were measured at a 3-mo follow-up visit using Majeed score modules.It was significantly better among the INFIX group than the EXFIX group in all three modules.At the final follow-up,both groups had no statistically significant difference according to the Majeed score;92.35 in the INFIX group and 90.99 in the EXFIX group(P=0.513).A lower surgical site infection rate was noticed in the INFIX group(P=0.007).CONCLUSION Anterior subcutaneous pelvis INFIX is associated with better radiological outcomes and a lower infection rate than anterior supra-acetabular EXFIX in managing patients with unstable anterior pelvic ring fractures.
文摘A stress analysis of the Sarafix external fixator design was performed using finite element analysis （FEA） and experimental tensometric measurements. The study was conducted at one of the Sarafix fixator configurations that have a clinical application in the treatment of tibia fractures. The intensity of principal and yon Mises stresses generated at two measuring points （MP） on the fixator connecting rod were monitored and analyzed during the testing on axial compression on the fixator design and its finite element model （FEM）. The 3D geometrical and FEM model of the fixator was formed using the computer aided design/computer aided engineering （CAD/CAE） software system CATIA. Verification of the results for the dominant principal stresses obtained from FEA was carried out through tensometric measurements. The measuring chain consisted of strain gauges connected into two Wheatstone half-bridges, digital measuring amplifier system and a computer with software for acquisition and monitoring of measurement results. A quite good agreement was observed between the results obtained on the basis of FEA and results of experimental tensometric analysis,
文摘Objective To evaluate effects of manipulative reduction,dynamic external fixator combined with limited internal fixation for the treatment of Pilon fractures.Methods From January 2007 to June 2009,manipulative reduction,dynamic external
文摘Objective To evaluate the clinical effects of Ilizarov external fixator for maluninon of obsolete calcaneal fracture of Stephen Type Ⅲ.Methods From July 2006 to February 2009,25 patients suffering from maluninon of obsolete calcaneal
基金National Key Research & Development Program of China(No.2017YFB1302901)
文摘The Ortho-SUV frame,a novel external fixator,can effectively treat limb deformities and fractures.Its kinematics is used when it is necessary to achieve bone movements with high precision.In this work,the kinematics model of the Ortho-SUV frame is established by six pose parameters,and its forward and inverse solutions are given.There is no need to solve nonlinear high-coupling equations with trigonometric functions in this solution method due to its special structure.By numerical examples and simulated orthopedic experiment of tibial fracture,the correctness and accuracy of the kinematics model and its solutions are verified.Besides,on the basis of kinematics analysis,the position workspace and orientation workspace of the Ortho-SUV frame are simulated in Matlab,which can help surgeons choose suitable device dimensions.The kinematics analysis provides a theoretical basis for the Ortho-SUV frame to be used in orthopedic treatment.
文摘Introduction: The Hybrid External Fixator combines the advantages of the monolateral pin fixators and the circular Ilizarov wire fixators. Principle of early motion has been touted as the functional savior of major intra articular injuries in application of hybrid external fixation. Materials & Methodology: 48 patients were considered for the study with tibial fractures admitted in Mamata General Hospital from May 2011 to May 2013. Results: The union and functional outcome of hybrid external fixator in simple and complex proximal and distal metaphyseal fractures of tibia in adults was evaluated at our centre. The fractures of the proximal tibia united with an average of 13.3 weeks (12 - 16 weeks). The fractures of the distal tibia united with an average of 14.42 weeks (13 - 22 weeks) with minimal complications. Conclusion: Our study shows high satisfaction rate after fixation, provides adequate stability and allows early motion of the joint. It is also effective in extra articular fractures occurring within 5 cm of the joint as the IM nails often do not provide enough stability and plating requires extensive soft tissue dissection.
文摘The objective of the present study was to investigate our novel methods for the repair of massive cartilage defects by joint distraction and motion using an external fixator. In this study, we used a rabbit model of massive articular cartilage defect in order to evaluate the effectiveness of using joint distraction and motion with a ring-type external fixator. This external fixator has a hinged joint with a center of rotation along the femoral transepicondylar axis, which allows the knee joint to freely flex and extend. Mesenchymal cells from bone marrow, induced by spongialization, were differentiated into mature chondrocytes and formed hyaline-like cartilage as a result of joint distraction and movement. The transplantation of autologous cells expanded from bone-marrow-derived mesenchymal cells, concentrated autologous bone marrow aspirate, and concentrated autologous peripheral blood cells were all effective in promoting cartilage repair. The quality of the cartilage after long-term joint distraction for 6 months was inferior to that after 12 weeks. In general, weight bearing on the regenerated cartilage promoted cartilage repair, although this effect differed based on when gradual weight bearing was begun. Specifically, gradual weight bearing beginning at 9 weeks produced superior results to that beginning at 6 weeks. Our methods provide an optimal environment for cartilage regeneration.
文摘BACKGROUND High tibial osteotomy(HTO)is a well-known procedure for the correction of knee varus.The purpose of this study was to compare the radiological results and accuracy of deformity correction performed using two different techniques:acute opening wedge correction using a plate and gradual correction with a monolateral external fixator.AIM To compare of the radiological results of two different techniques:acute opening wedge correction(a plate and screw)and gradual correction(external fixator).METHODS A total of 43 patients with plates and 36 patients with external fixators were included.All patients had moderate uniplanar varus deformities.We measured radiographic parameters,including the mechanical axis deviation(MAD),medial proximal tibial angle(MPTA),Caton-Deschamps Index(CDI),posterior proximal tibial angle,and joint line obliquity angle(JLOA).The accuracy of MAD correction was calculated based on a correction goal of neutral or overcorrection for medial compartment arthritis.RESULTS Demographics including age,body mass index,sex,and preoperative deformities were similar between the groups.The MAD significantly improved from 23.6 mm medial to the midline(SD=8.2 mm)to 6.9 mm lateral to the midline(SD=5.4 mm)(P<0.001).The accuracy of MAD correction did not differ between the groups and was 96.1%(SD=8.1%)in the plate group and 98.2%(SD=5.2%)in the external fixator group(P=0.18).The MPTA significantly improved from 83.9°(SD=2.9°)to 90.9°(SD=3.3°)(P<0.001),and the change was similar between the groups.Differences were noted in patella height,with a CDI change of-19.2%(SD=13.7%)and 3.1%(SD=8.0%)for the plate and external fixator groups,respectively(P<0.001).The change in JLOA was 1.6 degrees(SD=1.1 degrees)and 0.9 degrees(SD=0.9 degrees)for the plate and external fixator groups,respectively(P=0.04).CONCLUSION Reliable correction of moderate varus alignment was achieved with both the acute opening wedge technique with a plate and the gradual monolateral external fixator technique.The patellar height decreased with the open wedge plate technique.Joint line obliquity decreased to a greater degree with the open wedge plate technique,perhaps as a result of medial collateral ligament release.The appropriate technique should be selected based on surgeon and patient preferences;however,external fixation may be a better choice when the preservation of patellar height is deemed important.
文摘Objective: Unicameral bone cyst is a nonneoplasticbone lesion characterized by its tenacity and risk ofrecurrence. Pathological fracture is common and is often the presenting symptom. The objective of the present study was to evaluate the results of hybrid external fixator for thetreatment of a unicameral bone cyst with a pathologicalfracture. Methods: Hybrid external fixator for thetreatment of a unicameral bone cyst was performed intwelve patients. These patients presented with a pathological fracture and were managed immediately with hybridexternal fixator, of whom four had been managedconservatively at other clinics before they were referred toour department. The cyst was located in the proximalhumerus in all patients. The mean age of the patients at the time of surgery was 8.7 years, and the mean duration offollow-up was 32.6 months. Radiographic evaluation wasperformed according to the criteria of Capanna et al., andthe cyst was classified as completely healed, healed withresidual radiolucency (osteolysis), recurred, or having noresponse. Results: The healing period ranged from three to eight months. Eight cysts healed completely, and threehealed with residual radiolucent areas visible onradiographs. There was recurrence of one cyst that hadhealed with residual radiolucency. All of the cysts in thepresent study responded to treatment. A modulation ofhybrid external fixator was necessary in three patients, asthe bars had become too short after bone growth or the pins had been loose. No major complications were observed.Conclusion: Hybrid external fixator provides earlystability, which allows early mobilization and thus obviates the need for a plaster cast. This method of treatment alsoallows for an early return to normal activity.
基金This work was supported by Wuhan science & Technolgy Committee
文摘Four tibiae removed from 30-40 years males, who died of accidents in less than 12 hours, were os- teomized at medium part. Then these tibiae were fixed by an unilateral hooked-sulcated external fixator (UHSEF), and the bone-fixator system was used as a model of external fixation of tibial fracture. The axial compression, distraction, torsion, antero-posterior and lateral bending rigidly and the strain of the pins were determined in this system. Based on the results, we found that compared with the configuration of four paralled pins, the rigidity of the fan-like configuraton didn’t decrease significantly if the angle between lateral and medium pins was less than 45’. But the reverse was true when the frame separation increased from 5 to 8 cm. What’ more, the pin strain decreased if the rigidity of the system was improved. These data provided a theoretical basis of biomechanics for the improvement of UHSEF.
文摘After the first research with this technique done by the first author, ten operations on the foot and ankle were performed on five patients (two boys and three girls) suffering from severe club foot deformity all with bilateral foot affection. Their ages ranged from five to fourteen years. All of them were treated by soft tissue release, skin flap (rotational flap), supplemented with Alkhooly external fixator. The follow up period ranged from two to seven years. The results according to Mittal (1987) [1] were excellent in eight feet (80%) and good in two feet (20%).
文摘Objective: to explore the clinical nursing strategy of pelvic fracture patients after external fixator treatment. Methods: 82 patients with pelvic fracture admitted to our hospital from June 2019 to December 2020 were selected as the research objects and randomly divided into nursing group and control group. Among them, the patients in the control group were given routine nursing interventions in our hospital, and the patients in the nursing group were given comprehensive nursing interventions on this basis, and then the clinical nursing effects of the two groups were compared and analyzed. Results: the incidence of complications in nursing group was 2.44%, which was significantly lower than that in control group (21.95%). The average hospitalization time of patients in the control group was (20.7±3.5) days, which was significantly longer than that in the nursing group (14.5±2.2) days, with significant difference between the two groups (P<0.05). Conclusion: during the clinical treatment of patients with pelvic fracture, if comprehensive clinical nursing intervention measures can be taken on the basis of conventional external fixator treatment and nursing, the rehabilitation of patients can be accelerated, the hospitalization time of patients can be shortened, and the incidence of complications can be reduced.
文摘Objective: to explore the clinical value of external fixator in traumatic orthopedic cases. Methods: 86 cases of traumatic orthopedic diseases treated in our hospital from April 2020 to April 2021 were randomly divided into 43 cases in the observation group and 43 cases in the control group. In terms of treatment methods, the control group was treated with internal fixation, while the observation group was treated with external fixation. The rehabilitation treatment effects of the two groups were compared. Results: through surgical treatment, in the comparison of various index data, the treatment effect of the observation group was more effective than that of the control group. Conclusion: for the treatment of traumatic orthopedic diseases, the technical treatment with external fixator can promote the significant improvement of fracture and reduce the incidence of complications, which is worthy of popularization in clinic.
文摘Objective: To evaluate the effectiveness of the damage control, in emergency to treat the open tibial pilon fractures with Dolphix? External Fixator Frame(CITIEFFE?, Calderara di Reno, Bologna, Italy). Methods: From January 2017 to August 2017, at the Department of Orthopedics and Traumatology of Vito Fazzi Hospital Lecce, we treated 23 open tibial pilon fractures with Dolphix? External Fixator Frame(CITIEFFE?, Calderara di Reno, Bologna, Italy). The evaluation criteria of the case series were: the time needed to assemble the external fixator;the time taked to treat the ankle associated lesions;the time of skin healing;the ankle alignment;the subjective/objective Ovadia and Beals score;and complications. The Endpoint assessment was set at the days of the definitive surgery. Results: The results in terms of alignment, biomechanical stability of the frame, healing of soft tissue, complications were as good as the objective and subjective results according Ovadia and Beals score. Conclusion:Pilon fractures are complex and often present complications;the damage control treatment, in emergency, with Dolphix? External Fixator Frame(CITIEFFE?, Calderara di Reno, Bologna, Italy) permits a stable osteotaxis with minimal soft tissue damage and permit the repair of muscles, blood vessels and nerves with a stable bone and the soft tissue healing with vaccum therapy.
文摘Objective:To understand the current awareness and willingness to learn about the use of out-of-hospital automated external defibrillators(AEDs)in Deyang City,providing a basis for improving the success rate of rescue operations.Methods:A questionnaire survey was conducted among residents in Deyang City from January 2025 to October 2025,covering residents’basic information,awareness of AED-related knowledge,and attitudes towards AED usage.Results:A total of 1,886 questionnaires were collected,with 1,823 valid questionnaires,yielding an effective rate of 96.66%.Among the 1,823 respondents,692(37.96%)had received cardiopulmonary resuscitation(CPR)-related learning or training,619(33.96%)could accurately describe the name of an AED,417(22.87%)could clearly describe the function of an AED,and 308(16.89%)could accurately describe how to use an AED.Among them,1,549(84.97%)were willing to provide assistance to patients experiencing cardiac arrest;1,731(94.95%)were willing to provide assistance under the premise of knowing how to use an AED;and 1,750(95.99%)were willing to learn about AED-related knowledge.Among the 91 individuals unwilling to provide rescue,75 responded with reasons.Among them,36 cases(48.00%)were reluctant to rescue due to a lack of relevant first aid knowledge,32 cases(42.67%)expressed concerns about exacerbating the patient’s condition due to improper operation,and 4 cases(5.33%)were unwilling to interact with strangers due to personal reasons.Conclusion:Currently,residents in Deyang City have limited knowledge about AEDs but demonstrate a strong willingness to learn and apply them.Measures need to be taken to enhance their understanding and application of AEDs.
基金supported by the operating fund of Key Laboratory of Nuclear Power Systems and Equipment(Shanghai Jiao Tong University),Ministry of Education,China,the Natural Science Foundation of Shanghai Municipality(25ZR1402177)the National Natural Science Foundation of China(12105167)。
文摘Fuel-coolant interaction(FCI)remains one of the most complex challenges in severe accident research,with the triggering process being a key aspect that may govern subsequent fine fragmentation and potential steam explosions.In this study,the evolution characteristics of droplet-water interactions under external disturbance conditions were investigated using a self-designed FCI experimental setup.The experimental observations revealed that cavity formation reduced the drag force on the droplet,thereby increasing its peak velocity.However,the external disturbance pressure can disrupt the cavity,leading to a reduction in the droplet peak velocity.Furthermore,it was found that an increase in external disturbance pressure tended to increase the peak value of the droplet expansion rate,thereby promoting the fine-fragmentation process.This effect holds regardless of the initial droplet temperature,coolant temperature,or even when using droplet materials such as lead,which is generally considered unfavorable for steam explosions.Comparative analyses indicated that a higher external disturbance pressure may shorten the triggering time of the droplet surface and enhance the trigger intensity.These findings provide important phenomenological insights for further investigation of the triggering mechanisms in the initial stage of fuel-coolant interactions.
基金the National Key Research and Development Program of China(Grant No.2022YFB3404201)the National Natural Science Foundation of China(Grant Nos.52175335,52405342)+1 种基金the Natural Science Foundation Joint Foundation of Liaoning province(Grant No.2023-B SB A-108)the Fundamental Research Funds for the Central Universities(Grant No.N2402005)。
文摘The effects of the high pressure die casting(HPDC)processes on porosity,microstructure,and mechanical properties of heat-treatment-free aluminum silicon(Al-Si)alloys have long been a focal point in automotive die-casting research.In this work,the combined effect of shot sleeve materials and slow shot speeds on porosity,microstructure and mechanical properties of a newly designed HPDC Al-Si alloy was investigated.Results show that employing a ceramic shot sleeve or increasing the slow shot speed significantly reduces both the average size and area fraction of externally solidified crystals(ESCs),as well as the average pore size and volume fraction.When the slow shot speed is increased from 0.05 m·s^(-1)to 0.1 m·s^(-1),the pore volume fraction decreases by 10.2%in steel-shot-sleeve samples,compared to a substantial 67.1%reduction in ceramic-shot-sleeve samples.At a slow shot speed of 0.1 m·s^(-1),castings produced with a ceramic shot sleeve exhibit superior mechanical properties:8.3%higher yield strength,17.4%greater tensile strength,and an 81.4%improvement in elongation,relative to those from a steel shot sleeve.These findings provide valuable insights for minimizing porosity and coarse ESCs in die castings,offering promising potential for broader industrial applications.
文摘Basic life support for cardiac arrest associates cardiopulmonary resuscitation(CPR)and defibrillation.CPR relies on chest compressions(CC)and ventilation.Current guidelines on CPR recommend a depth of 5-6 cm at a rhythm of 100-120 times/min for CC.[1,2]Interruptions of the CC must be as short as possible and are related to ventilation,defibrillation and turnover of the rescuers.Most of the automated external defibrillators(AEDs)require interruptions of the CC to perform rhythm analysis.Among the numerous marketed models of AEDs,some provide real-time feedback about the quality of the CC.
文摘Five fresh tibias removed from 30-40 years old dead males were osteotomized at one-third supra-medium segment and then fixed by an unilateral adjustable external fixator (UAEF) to be used as a model of external fixation of tibial fracture. For each loading test under different configurations of UAEF, the ratio of the force-displacement was used to determine its stiffness value. The weakest mode of the UAEF device is in AP bending. Under each mode of compression,distraction , anteroposterial and lateral bending and torsion loading , increasing the pin number or pin diameter or pin separation, and/or reduction of pin group separation can significantly increase the stiffness values of UAEF (P<0.01). These data revealed that UAEF is suitable for the external fixation of tibial fracture.
