Biomechanical study of a low-cost external fixator for diaphyseal fractures of long bones.

Autor: Kouassi KJ; Experimental and Clinical Research Institute (IREC), Neuro-Musculo-Skeletal Pole (NMSK), Université Catholique de Louvain, Tour Pasteur +4 - 53 Avenue Emmanuel Mounier, 1200, Brussels, Belgium. medericko@yahoo.fr., Cartiaux O; Experimental and Clinical Research Institute (IREC), Neuro-Musculo-Skeletal Pole (NMSK), Université Catholique de Louvain, Tour Pasteur +4 - 53 Avenue Emmanuel Mounier, 1200, Brussels, Belgium.; Department of Health Engineering, ECAM Brussels Engineering School, Haute Ecole 'ICHEC-ECAM-ISFSC', Brussels, Belgium., Fonkoué L; Experimental and Clinical Research Institute (IREC), Neuro-Musculo-Skeletal Pole (NMSK), Université Catholique de Louvain, Tour Pasteur +4 - 53 Avenue Emmanuel Mounier, 1200, Brussels, Belgium., Detrembleur C; Experimental and Clinical Research Institute (IREC), Neuro-Musculo-Skeletal Pole (NMSK), Université Catholique de Louvain, Tour Pasteur +4 - 53 Avenue Emmanuel Mounier, 1200, Brussels, Belgium., Cornu O; Experimental and Clinical Research Institute (IREC), Neuro-Musculo-Skeletal Pole (NMSK), Université Catholique de Louvain, Tour Pasteur +4 - 53 Avenue Emmanuel Mounier, 1200, Brussels, Belgium.; Department of Orthopedics and Trauma, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
Jazyk: angličtina
Zdroj: Journal of orthopaedic surgery and research [J Orthop Surg Res] 2020 Jul 06; Vol. 15 (1), pp. 247. Date of Electronic Publication: 2020 Jul 06.
DOI: 10.1186/s13018-020-01777-5
Abstrakt: Background: External fixation improves open fracture management in emerging countries. However, sophisticated models are often expensive and unavailable. We assessed the biomechanical properties of a low-cost external fixation system in comparison with the Hoffmann® 3 system, as a reference.
Methods: Transversal, oblique, and comminuted fractures were created in the diaphysis of tibia sawbones. Six external fixators were tested in three modes of loading-axial compression, medio-lateral (ML) bending, and torsion-in order to determine construction stiffness. The fixator construct implies two uniplanar (UUEF1, UUEF2) depending the pin-rods fixation system and two biplanar (UBEF1, UBEF2) designs based on different bar to bar connections. The designed low-cost fixators were compared to a Hoffmann® 3 fixator single rod (H3-SR) and double rod (H3-DR). Twenty-seven constructs were stabilized with UUEF1, UUEF2, and H3-SR (nine constructs each). Nine constructs were stabilized with UBEF1, UBEF2, and H3-DR (three constructs each).
Results: UUEF2 was significantly stiffer than H3-SR (p < 0.001) in axial compression for oblique fractures and UUEF1 was significantly stiffer than H3-SR (p = 0.009) in ML bending for transversal fractures. Both UUEFs were significantly stiffer than H3-SR in axial compression and torsion (p < 0.05), and inferior to H3-SR in ML bending, for comminuted fractures. In the same fracture pattern, UBEFs were significantly stiffer than H3-DR (p = 0.001) in axial compression and torsion, while only UBEF1 was significantly stiffer than H3-DR in ML bending (p = 0.013).
Conclusions: The results demonstrated that the stiffness of the UUEF and UBEF device compares to the reference fixator and may be helpful in maintaining fracture reduction. Fatigue testing and clinical assessment must be conducted to ensure that the objective of bone healing is achievable with such low-cost devices.
Databáze: MEDLINE
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