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Biomechanical study of a low-cost external fixator for diaphyseal fractures of long bones
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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7339426/ https://www.ncbi.nlm.nih.gov/pubmed/32631381 http://dx.doi.org/10.1186/s13018-020-01777-5 |
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author | Kouassi, Kouamé Jean-Eric Cartiaux, Olivier Fonkoué, Loic Detrembleur, Christine Cornu, Olivier |
author_facet | Kouassi, Kouamé Jean-Eric Cartiaux, Olivier Fonkoué, Loic Detrembleur, Christine Cornu, Olivier |
author_sort | Kouassi, Kouamé Jean-Eric |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7339426 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-73394262020-07-09 Biomechanical study of a low-cost external fixator for diaphyseal fractures of long bones Kouassi, Kouamé Jean-Eric Cartiaux, Olivier Fonkoué, Loic Detrembleur, Christine Cornu, Olivier J Orthop Surg Res Research Article 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. BioMed Central 2020-07-06 /pmc/articles/PMC7339426/ /pubmed/32631381 http://dx.doi.org/10.1186/s13018-020-01777-5 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Kouassi, Kouamé Jean-Eric Cartiaux, Olivier Fonkoué, Loic Detrembleur, Christine Cornu, Olivier Biomechanical study of a low-cost external fixator for diaphyseal fractures of long bones |
title | Biomechanical study of a low-cost external fixator for diaphyseal fractures of long bones |
title_full | Biomechanical study of a low-cost external fixator for diaphyseal fractures of long bones |
title_fullStr | Biomechanical study of a low-cost external fixator for diaphyseal fractures of long bones |
title_full_unstemmed | Biomechanical study of a low-cost external fixator for diaphyseal fractures of long bones |
title_short | Biomechanical study of a low-cost external fixator for diaphyseal fractures of long bones |
title_sort | biomechanical study of a low-cost external fixator for diaphyseal fractures of long bones |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7339426/ https://www.ncbi.nlm.nih.gov/pubmed/32631381 http://dx.doi.org/10.1186/s13018-020-01777-5 |
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