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Archives of orthopaedic and traumatic surgery

, Volume 102, Issue 4, pp 242–247 | Cite as

The stability of union in tibial shaft fractures: Its measurement by a non-invasive method

  • Edholm P. 
  • R. Hammer
  • S. Hammerby
  • B. Lindholm
Original Articles

Summary

The stability of the union in tibial shaft fractures was followed by repeated non-invasive radiographic measurement of a deflection induced in the area of the fracture. By means of a Shift Comparator the difference in the angle between the two fragments before and during application of the deflecting force can be measured. The relative measure of the strength of the union is furnished by a quantity, the deflection ratio, which is based on the quotient of the induced deflection by the magnitude of the applied bending moment. When this ratio falls below a certain value the union is considered to be stable enough for full weight bearing during walking. A plot of the deflection ratio against time, with logarithmic scales on both axes had a negative slope and was more or less linear. This graph can serve as an aid in detecting the course of union, in deciding when the cast should be removed, and in detecting any irregularity in the process of union. In the management of 207 fractures of the tibial shaft 508 such deflection measurements were performed.

Keywords

Public Health Logarithmic Scale Relative Measure Weight Bearing Negative Slope 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Zusammenfassung

Die Stabilitätsentwicklung von 207 Tibiafrakturen wurde mit einer nichtinvasiven Untersuchung verfolgt. Vom Unterschenkel werden in einem standardisierten Verfahren ap-Röntgenaufnahmen mit und ohne Biegemoment gemacht. Diese werden in einem optischen Apparat (Komparoscop) verglichen. Der Deformationswinkel kann so mit großer Sicherheit bestimmt werden. Aus dem Biegemoment und dem Winkel ergibt sich eine Druck-Deformationsbeziehung. Dieser Wert wird für das Gewicht des Patienten korrigiert. Wir nennen ihn „Deflektionsrate”. Nach unseren Erfahrungen ist die Stabilität bei kleineren Werten als 0,08 für volle Belastung beim Gehen ausreichend. Die „D-Raten” werden in ein doppellogarithmisches Koordinatensystem eingetragen. Die meisten Frakturen zeigten dabei eine gradlinige Stabilitätsentwicklung. Ein Abweichen vom geraden Verlauf ist als Hinweis auf eine Pseudarthrosenentwicklung zu verwerten.

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Copyright information

© Springer-Verlag 1984

Authors and Affiliations

  • Edholm P. 
    • 1
  • R. Hammer
    • 2
  • S. Hammerby
    • 1
  • B. Lindholm
    • 1
  1. 1.Department of Diagnostic RadiologyLinköping University Medical SchoolLinköpingSweden
  2. 2.Department of Orthopedic SurgeryLinköping University Medical SchoolLinköpingSweden

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