Parametric analyses of pin-bone stresses in external fracture fixation devices.

Problems occurring in the use of external fixators for bone fractures include pin-bone interface necrosis, infection, and loosening. These may be initiated and enhanced by pin-bone interface stress levels. Based on stress data from finite element method (FEM) models, an analytical "closed-form" model of the local pin-bone configuration in long-bone fracture fixation is developed. This model is relatively simple and useful for routine applications in combination with clinical studies and animal experiments. Although approximate, the most significant stress predictions in the pin-bone structure compare well with more sophisticated FEM analysis results. The analytical model is used for extensive parametric analyses, investigating the effects on the pin-bone interface stress distribution of frame configuration parameters, pin diameter and modulus, bone dimensions, and elastic characteristics. The results indicate that these stresses may reach very high levels under unfavorable circumstances but can be drastically reduced by increasing the bending rigidity of the pin, reducing the side-bar separation and applying full-pin configuration in favor of half-pins.