Ye Xubiao, Luo Jinling, Chen Pu, Wei Xiaohua, Liu Shifeng
Department of Traumatic Orthopaedic, Dongguan Eighth People's Hospital, 68 Xihu Road, Shilong, Dongguan, Guangdong, 523000, China.
Key Laboratory of Orthopaedic Biomaterials Research and Clinical Translation, Dongguan, Guangdong, 532325, China.
BMC Musculoskelet Disord. 2025 Mar 27;26(1):304. doi: 10.1186/s12891-025-08530-1.
External fixators have been extensively applied in the treatment of open tibiofibular fractures and have yielded positive outcomes. The stability of an external fixator primarily hinges on its structure. Employing additional external fixation components can undoubtedly enhance stability. However, there is scant research on the topic of achieving superior stability with fewer external fixation components.
Utilizing 3D modeling software, constructed three different external fixation models in middle tibial fractures in Group A, constructed four external fixation models in proximal tibial fractures in Group B, and constructed four external fixation models in distal tibial fractures in Group C.Simulate the load under the assistance of a walker to stand up, obtain the displacement of fractures and the stress of the external fixator for each group. Analyze and compare the results of each model.
In a mid-tibial fracture, the stability of the crossbar increases by 21% with each 2 cm closer to the tibia. Model B3 achieves superior stability with the use of more fixed clamps and connecting rods in the "H" shaped model. Although the triangular cross-bar structure used in Model B4 is less stable than that of Model B3, it has achieved 83.2% of the stability of Model B3, despite using fewer components. The stability of Model C4 has increased by 73.44% compared to Model C3.
The external fixator should be configured to keep the crossbar as close to the skin as possible. For proximal tibial fractures, to minimize the use of external fixation components, the triangular cross-bar structure of Model B4 can be employed. In the case of distal tibial fractures, while the triangular cross-bar structure of Model C4 offers good stability, the risk of displacement is greater. Therefore, it is advisable to use an H-shaped fixation method with additional external fixation components, such as those found in Model C3.
外固定器已广泛应用于开放性胫腓骨骨折的治疗，并取得了积极的效果。外固定器的稳定性主要取决于其结构。使用额外的外固定组件无疑可以增强稳定性。然而，关于使用更少的外固定组件实现更高稳定性这一主题的研究却很少。
利用三维建模软件，在A组胫骨中段骨折中构建三种不同的外固定模型，在B组胫骨近端骨折中构建四种外固定模型，在C组胫骨远端骨折中构建四种外固定模型。在助行器辅助下模拟站立时的负荷，获取每组骨折的位移和外固定器的应力。分析并比较各模型的结果。
在胫骨中段骨折中，横杆每靠近胫骨2 cm，稳定性增加21%。B3模型通过在“H”形模型中使用更多的固定夹和连接杆实现了更高的稳定性。尽管B4模型中使用的三角形横杆结构比B3模型的稳定性差，但尽管使用的组件较少，它仍达到了B3模型稳定性的83.2%。C4模型的稳定性比C3模型提高了73.44%。
外固定器应配置为使横杆尽可能靠近皮肤。对于胫骨近端骨折，为尽量减少外固定组件的使用，可采用B4模型的三角形横杆结构。在胫骨远端骨折的情况下，虽然C4模型的三角形横杆结构提供了良好的稳定性，但位移风险更大。因此，建议使用带有额外外固定组件的H形固定方法，如C3模型中的方法。
