Pugh K J, Wolinsky P R, Pienkowski D, Banit D, Dawson J M
Department of Surgery, University of Kentucky, Lexington 40536-0284, USA.
J Orthop Trauma. 1999 Aug;13(6):418-25. doi: 10.1097/00005131-199908000-00005.
To compare the elastic stiffness, in several loading modes, of commercially available hybrid external fixation systems.
Laboratory investigation using a polyvinylchloride pipe periarticular tibia fracture model.
Simulated periarticular fractures were created in an in vitro tibia fracture model. Instrumented specimens and intact controls were elastically tested in a biomaterials testing system.
Groups of simulated periarticular tibia fractures were stabilized with one of six different hybrid external fixator designs.
Elastic stiffness of each specimen was measured in compression, torsion, flexion bending, extension bending, and varus/valgus bending.
Fixators with multiple levels of fixation in the periarticular fragment, regardless of design, were stiffer than those with one level. Specifically, the EBI Ring Connector fixator was stiffer than all others in all modes of testing. The Ace, Synthes, Smith & Nephew Richards, and How medica fixators were mechanically similar. The Zimmer Torus fixator was the least stiff fixator tested.
Fixators with multiple levels of fixation in the periarticular fragment, regardless of design, were stiffer than those with one level. The choice of which hybrid external fixator to use should be made based not only on stiffness but also on ease of clinical application, patient comfort, customer support from the manufacturer, and cost. Clinical investigation of the efficacy of each of these devices is warranted.
比较市售混合外固定系统在几种加载模式下的弹性刚度。
使用聚氯乙烯管关节周围胫骨骨折模型进行实验室研究。
在体外胫骨骨折模型中制造模拟关节周围骨折。在生物材料测试系统中对仪器化标本和完整对照进行弹性测试。
用六种不同的混合外固定器设计之一稳定模拟关节周围胫骨骨折组。
在压缩、扭转、屈曲弯曲、伸展弯曲和内翻/外翻弯曲中测量每个标本的弹性刚度。
无论设计如何，关节周围骨折块有多级固定的固定器比只有一级固定的固定器更硬。具体而言，EBI环形连接器固定器在所有测试模式下都比其他所有固定器更硬。Ace、Synthes、施乐辉理查兹和豪美迪卡固定器在力学上相似。Zimmer Torus固定器是测试中最不硬的固定器。
无论设计如何，关节周围骨折块有多级固定的固定器比只有一级固定的固定器更硬。选择使用哪种混合外固定器不仅应基于刚度，还应基于临床应用的便利性、患者舒适度、制造商的客户支持和成本。对这些装置中每一种的疗效进行临床研究是有必要的。
