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Variables Altering the Mechanical Characteristics of Fixator Frames

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Biomechanics: Current Interdisciplinary Research

Part of the book series: Developments in Biomechanics ((DEBI,volume 2))


External fixators allow the manipulation and immobilization of fractures through pins which have been percutaneously inserted into each main bony fragment and are externally connected by one or more longitudinal bars. Recognized as an attractive concept in the middle of the 19th century, a high rate of complications such as pin tract osteomyelitis, loss of reduction, and component failures have prevented for many decades the regular use of these devices. Since the introduction of more stable bilateral frames (transfixion pins are connected over two or more medial and lateral connecting rods) over a decade ago (1), external fixation has become the preferred method for the immobilization of severe open diaphyseal fractures and osseous infections. While bilateral frames have remained popular, their safety, particularly in the lower leg where most fixators are applied, is being increasingly questioned (2,5). Multiple transfixion pins have caused anterior compartment syndromes, lacerations of the anterior tibial vessels, injuries to the saphenous and superficial peroneal nerves, and frequently lead to at least partial stiffness of the ankle and subtalar joints (5,6). It also has become obvious that these frames are weakest in the sagittal plane where clinically the largest bending moments apply (8). A search for safer fixator configuration has recently led to the rediscovery of one and two-plane unilateral configurations which occupy a cross-sectional sector of less than 90 degrees and therefore can be applied to the anteromedial aspect of the leg without jeopardizing vital neurovascular structures and musculotendinous units (2). While clinically attractive, the limited rigidity of these configurations has been held responsible for the many complications that affected the use of external fixators in the past (1,7,9).

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© 1985 Martinus Nijhoff Publishers, Dordrecht

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Behrens, F., Johnson, W.D. (1985). Variables Altering the Mechanical Characteristics of Fixator Frames. In: Perren, S.M., Schneider, E. (eds) Biomechanics: Current Interdisciplinary Research. Developments in Biomechanics, vol 2. Springer, Dordrecht.

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  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-011-7434-3

  • Online ISBN: 978-94-011-7432-9

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