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
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
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
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
BACKGROUND Closed reduction and internal fixation with intramedullary nails has been widely accepted for treating intertrochanteric fractures.AIM To focus on how to avoid displacement of the lesser trochanter in unsta...BACKGROUND Closed reduction and internal fixation with intramedullary nails has been widely accepted for treating intertrochanteric fractures.AIM To focus on how to avoid displacement of the lesser trochanter in unstable intertrochanteric fractures.METHODS We developed a lesser trochanteric reduction fixator for treating intertrochanteric fractures through fixing the lesser trochanter by combining the loop plate through the fixator after reduction by the reducer.Five patients with intertrochanteric fractures treated with the newly developed lesser trochanteric reduction fixator and loop plate combined with intramedullary nails,and 20 patients with intertrochanteric fractures treated with simple intramedullary nails were selected from December 2020 to March 2021.RESULTS The postoperative Harris hip score was significantly higher in patients treated with the lesser trochanteric reduction fixator than in patients treated without the lesser trochanteric reduction fixator,which indicated that this lesser trochanteric reduction fixator had a positive impact on rehabilitation of the hip joint after surgery and could significantly improve the quality of life of patients.CONCLUSION We fully realize the significance of trochanteric reduction and fixation,namely,reconstruction of structures under pressure,in the treatment of intertrochanteric fractures.As long as the general condition of patients is favorable and they are willing to undergo surgery,fixation of the main fracture end should be performed and the lesser trochanter should be reduced and fixed at the same time.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
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
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
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
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 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 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 outcomes of external fixator with lumbopelvic distraction spondylodesis in treatment of vertically unstable pelvic fractures.Methods From January 2008 to March 2009,9 patients(4 male...Objective To evaluate the clinical outcomes of external fixator with lumbopelvic distraction spondylodesis in treatment of vertically unstable pelvic fractures.Methods From January 2008 to March 2009,9 patients(4 males and 5 females)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
BACKGROUND： With the development of internal fixation materials, simple operation with internal fixation has become a tendency. Ni-Ti shape memory alloy embracing fixator has such advantages as slight injury, easy op...BACKGROUND： With the development of internal fixation materials, simple operation with internal fixation has become a tendency. Ni-Ti shape memory alloy embracing fixator has such advantages as slight injury, easy operation, security, reliable fixation, and better histocompatibility. The present study was to explore curative effect and postoperative results of Ti-Ni shape memory alloy embracing ？ xator in patients with multiple fractured ribs and ？ ail chest.METHODS： The curative effect and long-term follow-up results were observed after internal ？ xation with a shape memory alloy embracing ？ xator in patients with multiple fractured ribs and ？ ail chest from January 2006 to December 2009.RESULTS： All patients were cured with an average hospital stay of 10.31±3.14 days. Post-operative pain was less severe than preoperative pain （P=0.02）.The rate of postoperative complications such as atelectasis, pulmonary infection, etc was 17.65%. There were fewer long-term complications and less in？ uence on daily work and life.CONCLUSIONS： It is practical to perform an operation for fracture of multiple ribs using a Ti-Ni shape memory alloy embracing ？ xator. The ？ xator, which is less traumatic, simple, safe, and reliable, has a good-histocompatibility and fewer postoperative complications.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
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.
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BACKGROUND Closed reduction and internal fixation with intramedullary nails has been widely accepted for treating intertrochanteric fractures.AIM To focus on how to avoid displacement of the lesser trochanter in unstable intertrochanteric fractures.METHODS We developed a lesser trochanteric reduction fixator for treating intertrochanteric fractures through fixing the lesser trochanter by combining the loop plate through the fixator after reduction by the reducer.Five patients with intertrochanteric fractures treated with the newly developed lesser trochanteric reduction fixator and loop plate combined with intramedullary nails,and 20 patients with intertrochanteric fractures treated with simple intramedullary nails were selected from December 2020 to March 2021.RESULTS The postoperative Harris hip score was significantly higher in patients treated with the lesser trochanteric reduction fixator than in patients treated without the lesser trochanteric reduction fixator,which indicated that this lesser trochanteric reduction fixator had a positive impact on rehabilitation of the hip joint after surgery and could significantly improve the quality of life of patients.CONCLUSION We fully realize the significance of trochanteric reduction and fixation,namely,reconstruction of structures under pressure,in the treatment of intertrochanteric fractures.As long as the general condition of patients is favorable and they are willing to undergo surgery,fixation of the main fracture end should be performed and the lesser trochanter should be reduced and fixed at the same time.
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.
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 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 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 outcomes of external fixator with lumbopelvic distraction spondylodesis in treatment of vertically unstable pelvic fractures.Methods From January 2008 to March 2009,9 patients(4 males and 5 females)
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
文摘BACKGROUND： With the development of internal fixation materials, simple operation with internal fixation has become a tendency. Ni-Ti shape memory alloy embracing fixator has such advantages as slight injury, easy operation, security, reliable fixation, and better histocompatibility. The present study was to explore curative effect and postoperative results of Ti-Ni shape memory alloy embracing ？ xator in patients with multiple fractured ribs and ？ ail chest.METHODS： The curative effect and long-term follow-up results were observed after internal ？ xation with a shape memory alloy embracing ？ xator in patients with multiple fractured ribs and ？ ail chest from January 2006 to December 2009.RESULTS： All patients were cured with an average hospital stay of 10.31±3.14 days. Post-operative pain was less severe than preoperative pain （P=0.02）.The rate of postoperative complications such as atelectasis, pulmonary infection, etc was 17.65%. There were fewer long-term complications and less in？ uence on daily work and life.CONCLUSIONS： It is practical to perform an operation for fracture of multiple ribs using a Ti-Ni shape memory alloy embracing ？ xator. The ？ xator, which is less traumatic, simple, safe, and reliable, has a good-histocompatibility and fewer postoperative complications.
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.
