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Vet Comp Orthop Traumatol 1999; 12(03): 108-117
DOI: 10.1055/s-0038-1632475
Clinical Communication
Schattauer GmbH

Initial Clinical Experience with the IMEX™ Circular External Skeletal Fixation System

Part I: Use in Fractures and Arthrodeses
D. D. Lewis
1   From the Department of Small Animal Clinical Sciences and the Center for Veterinary Sports Medicine, College of Veterinary Medicine, University of Florida Gainesville
,
R. M. Radasch
2   Dallas Veterinary Surgical Center, Dallas
,
B. S. Beale
3   Gulf Coast Veterinary Specialists, Houston
,
J. T. Stallings
1   From the Department of Small Animal Clinical Sciences and the Center for Veterinary Sports Medicine, College of Veterinary Medicine, University of Florida Gainesville
,
O. I. Lanz
1   From the Department of Small Animal Clinical Sciences and the Center for Veterinary Sports Medicine, College of Veterinary Medicine, University of Florida Gainesville
,
R. D. Welch
4   Texas Scottish Rite Hospital for Children, Dallas, USA
,
M.L. Samchukov
4   Texas Scottish Rite Hospital for Children, Dallas, USA
› Author Affiliations
Further Information

Publication History

Received 18 June 1998

Accepted 19 February 1999

Publication Date:
09 February 2018 (online)

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Summary

The IMEX™ Circular External Skeletal Fixation (CESF) System was used to stabilize fractures (12 radius and ulna and five tibia and fibula) in 15 dogs and two cats and arthrodeses (two pancarpal, one talocrural and one pantarsal) in four dogs. The ages of the animals with fractures ranged from six months to nine years (mean ± SD: 2.7 ± 2.5 years; median: 2.0 years) and the body weights of dogs with fractures ranged from 5.4 kg to 48.6 kg (mean ± SD: 21.3 ± 12.6 kg; median: 22.7 kg). The ages of the dogs having arthrodeses ranged from eight months to two years (mean ± SD: 18±10 months; median: 18 months) and body weights of dogs with arthrodeses ranged from 19.0 kg to 29.1 kg (mean ± SD: 22.7 ± 4.7 kg; median: 21.4 kg). Ten fractures were open and four had been previously managed with another form of stabilization. Ten fractures were comminuted and all of the fractures involved the diaphysis; two extended to the distal metaphysis. An extensive open reduction was used on three, a limited open reduction on seven and a closed reduction on seven fractures. Arthrodeses were performed via a limited open approach, for debridement of the articular cartilage and implantation of a cancellous bone graft. Most animals placed substantial weight on the affected limb within a few days following the operations. Wire and pin track inflammation was the most common complication during the convalescent period and was often associated with a decrease in weight-bearing. Sixteen fractures achieved radiographic union (mean ± SD: 46 ± 13 days; median: 43 days) long-term function (direct examination: mean ± SD: 76 ± 38 days; median: 43 days; telephone communication: mean ± SD: 366 ± 247 days; median: 381 days) was assessed as excellent in 10 animals and good in seven. All of the arthrodeses achieved radiographic union (mean ± SD: 74 ± 31 days; median: 71 days). Longterm function (direct examination: mean ± SD: 185 ± 182 days; median: 102 days; telephone communication: mean ± SD: 485 ± 22 days; median: 590 days) was assessed as good in two dogs and fair in two dogs. Our results establish the utility of the IMEX™ CESF System for stabilizing fractures and performing arthrodeses in dogs and cats.

The IMEX™ Circular External Fixator System was used to stabilize radius and ulna or tibia and fibula-fractures in 15 dogs and two cats and perform arthrodeses ir four dogs. Sixteen fractures and all four arthrodeses achieved radiographic union. Limb function was assessed as excellent in ten animals, good in nine animals and fair in two dogs.

Presented at the 23rd Annual Conference of the Veterinary Orthopaedics Society, Telluride, CO, USA March 5, 1996 University of Florida Journal Series #547.

Keywords

Fracture - arthrodesis - circular external fixation
 

  • REFERENCES

  • 1 AS AMI Group. Basic principles of operative technique. In: Operative Principals of Ilizarov. Bianchi-Maiocchi A, Aronson J. Eds Milan, Italy: Medi Surgical Vido; 1991: 65-72.
    Google Scholar
  • 2 Bianchi-Maiocchi A. Instruments and their use. In: Operative Principals of Ilizarov. Bianchi-Maiocchi A, Aronson J. eds Milan, Italy: Medi Surgical Vido; 1991: 9-32.
    Google Scholar
  • 3 Bianchi-Maiocchi A. The Ilizarov compression- distraction apparatus. In: Advances in Ilizarov Apparatus Assembly. Bianchi- Maiocchi A. Ed Milan, Italy: Medicalplastic srl; 1994: 5-14.
    Google Scholar
  • 4 Bronson DG, Samchukov M, Birch J. Small bone fragment segmental fixation with the Ilizarov apparatus: A mechanical evaluation. 5th Annual ASAMI Scientific Meeting, Paper #6. 1995: 6.
    Google Scholar
  • 5 Calhoun JH, Li F, Bauford WL, Lehman T. et al Rigidity of half-pins for the Ilizarov external fixator. Bulletin Hosp Joint Diseases 1992; 52: 21-6.
    PubMedGoogle Scholar
  • 6 Calhoun JH, Li F, Ledbetter BR, Gill CA. Biomechanics of the Ilizarov fixator for fracture fixation. Clin Orthop 1992; 280: 15-22.
    PubMedGoogle Scholar
  • 7 Catagni M. Fractures of the tibia-fibula. In: Advances in Ilizarov Apparatus Assembly. Bianchi-Maiocchi A. Ed Milan, Italy: Medicalplastic srl; 1994: 48-58.
    Google Scholar
  • 8 Catagni M. Fractures of the leg (tibia). In: Operative Principals of Ilizarov. Bianchi- Maiocchi A, Aronson J. eds Milan, Italy: Medi Surgical Vido; 1991: 91-124.
    Google Scholar
  • 9 Dudley M, Johnson AL, Olmstead M. et al Open reduction and bone plate stabilization, compared with closed reduction and external fixation, for treatment of comminuted tibial fractures: 47 cases (1980-1995) in dogs. J Am Vet Med Assoc 1997; 211: 1008-12.
    PubMedGoogle Scholar
  • 10 Elkins AD, Morandi M. The Ilizarov ring fixator: Principles, techniques, and uses. In: Textbook of Small Animal Surgery. Vol II. Slatter DH. ed Philadelphia: WB Saunders; 1993: 1656-61.
    Google Scholar
  • 11 Elkins AD, Morandi M, Zembo M. Distraction osteogenesis in the dog using the Ilizarov external ring fixator. J Am Anim Hosp Assoc 1993; 29: 419-26.
    PubMedGoogle Scholar
  • 12 Ferretti A. The application of the Ilizarov technique to veterinary medicine. In: Operative Principals of Ilizarov. Bianchi-Maiocchi A, Aronson J. eds Milan, Italy: Medi Surgical Vido; 1991: 551-70.
    Google Scholar
  • 13 Fox SM. Bray JC, Guerin SR. et al Antebrachial deformities in the dog: treatment with external fixation. J Small Anim Pract 1995; 36: 315-20.
    CrossrefPubMedGoogle Scholar
  • 14 Green SA, Harris LN, Wall DM. et al The Rancho mounting technique for the Ilizarov method. A preliminary report. Clin Ortho 1992; 280: 104-16.
    PubMedGoogle Scholar
  • 15 Hay CW, Manley P. Use of the Wagner apparatus to lengthen the antebrachium of a growing dog. J Small Anim Pract 1996; 37: 543-8.
    CrossrefPubMedGoogle Scholar
  • 16 Ilizarov GA. The tension-stress effect on the genesis and growth of tissues. Part I. The influence of stability of fixation and softtissue preservation. Clin Ortho 1989; 238: 249-81.
    CrossrefPubMedGoogle Scholar
  • 17 Ilizarov GA. The tension-stress effect on the genesis and growth of tissue. Part II. The influence of the rate and frequency of distraction. Clin Ortho 1989; 239: 263-85.
    PubMedGoogle Scholar
  • 18 Ilizarov GA. Clinical application of the tension- stress effect for limb lengthening. Clin Ortho 1990; 250: 8-26.
    PubMedGoogle Scholar
  • 19 Ilizarov GA. The apparatus: Components and biomechanical principles of application. In: Transosseous Osteosynthesis. Theoretical and Clinical Aspects of the Regeneration and Growth of Tissue. Ilizarov GA. ed Berlin: Springer-Verlag; 1992: 63-136.
    Google Scholar
  • 20 Johnson AL, Seitz SE, Smith CW. et al Closed reduction and type-II external fixation of comminuted fractures of the radius and tibia in dogs: 23 cases (1990-1994). J Am Vet Med Assoc 1996; 209: 1445-8.
    PubMedGoogle Scholar
  • 21 Langley-Hobbs SJ, Carmichael S, Pead MJ. et al Management of antebrachial deformity and shortening secondary to a synostosis in a dog. J Small Anim Pract 1996; 37: 359-63.
    CrossrefPubMedGoogle Scholar
  • 22 Latte Y. Studies of 63 cases treated by Ilizarov apparatus: Indications, results, complications. Proc Vet Orthop Soc. 1993: 12.
    Google Scholar
  • 23 Lesser AS. Ilizarov technique. In: Current Techniques in Small Animal Surgery. 4thedition.. Bojrab MJ. ed Baltimore: Williams & Wilkins; 1998: 950-63.
    Google Scholar
  • 24 Lewis DD. Management of penetrating joint injuries. Vet Clin North Am 1995; 25: 1197-223.
    CrossrefPubMedGoogle Scholar
  • 25 Lewis DD, Bronson DG, Samchukov ML. et al Biomechanics of circular external skeletal fixation. Vet Surg 1998; 27: 454-64.
    CrossrefPubMedGoogle Scholar
  • 26 Marcellin-Little DJ, Ferretti A, Roe SC. et al Hinged Ilizarov external fixation for correction of antebrachial deformities. Vet Surg 1998; 27: 231-45.
    CrossrefPubMedGoogle Scholar
  • 27 Paley D. Biomechanics of the Ilizarov external fixator. In: Operative Principals of Ilizarov. Bianchi-Maiocchi A, Aronson J. eds Milan, Italy: Medi Surgical Vido; 1991: 31-41.
    Google Scholar
  • 28 Podolsky A, Chao EYS. Mechanical performance of Ilizarov circular external fixators in comparison with other external fixators. Clin Orthop 1993; 293: 61-70.
    PubMedGoogle Scholar
  • 29 Stallings JT, Lewis DD, Welch RD. et al An introduction to distraction osteogenesis and the principles of the Ilizarov method. Vet Comp Orthop Traumatol 1998; 11: 59-67.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 30 Tillson DM. Open fracture management. Vet Clin North Am 1995; 25: 1093-110.
    CrossrefPubMedGoogle Scholar
  • 31 Tommasini MD, Betts CW. Use of the "Ilizarov" external fixator in a dog. Vet Comp Orthop Traumatol 1991; 4: 70-6.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 32 Trostel CT Radesch. Tarsoconral arthrodesis: a clinical report using a circular external fixator. Vet Comp Orthop Traumatol 1998; 11: 193-6.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 33 Waanders NA, Lawton JN, Steen H. et al Clinical estimate of Ilizarov fixator axial stiffness based on wire and half-pin contributions. Bulletin Hospital Joint Disease 1993- 1995; 53: 10-2.
    PubMedGoogle Scholar
  • 34 Yanoff SR, Hulse DA, Palmer RH. et al Distraction osteogenesis using modified external fixation devices in five dogs. Vet Surg 1992; 21: 480-7.
    CrossrefPubMedGoogle Scholar