External Fracture Fixation—the Analysis and Design of a New System

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Abstract
External skeletal fixation of long bone fractures is the procedure of choice for the treatment of certain clearly established types of fracture. In particular, it is appropriate when the skin and soft tissue at the site of the fracture is at risk and requires careful management. For sound bone union to be achieved correct orientation and stability of the fracture is needed. A rigid fixation method is therefore required, and this rigidity determines the degree of post-operative mobility that the patient can exercise during the healing phase. A single-sided fixation system when applied, for example, to the medial aspect of the tibia, which gives adequate skeletal support, would be preferred to a double-sided unit as it would not inhibit the action of muscles, would reduce the number of pin holes, and be more convenient for the patient. From experience with existing equipment available for this surgical technique, a specification to meet the performance criteria needed was drawn up, and from this a design emerged giving priority to aspects of stiffness and convenience. The report concludes with three case studies of patients treated with this fixator. A separate paper gives the results of practical tests on this fixator, with a theoretical analysis of the factors which influence stiffness in single-sided fixators, and of the strength which can be expected.