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Vet Comp Orthop Traumatol 2002; 15(02): 104-110
DOI: 10.1055/s-0038-1632722
Clinical Communication
Schattauer GmbH

The unilateral external fixator and acrylic connecting bar, combined with I.M pin, for the treatment of tibial fractures

J. Shani
1   Animal Medical Center Netanya, Israel
,
R. Shahar
2   Section of Surgery, Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Israel
› Author Affiliations
Further Information

Publication History

Received 04 May 2001

Accepted 10 August 2001

Publication Date:
07 February 2018 (online)

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Summary

A unilateral external skeletal fixator (ESF) system with an acrylic connecting bar, combined with an intramedullary (I.M) pin, was used to treat simple, comminuted and open fractures of the tibia in 12 clinical cases occurring in large and small dogs, and in cats. A minimal surgical approach was used in all cases. The I.M pin was placed first, in the normograde fashion, to align the tibial fragments. Transfixation pins were then inserted from the medial side, using previously published guidelines for safe corridors in the tibia (30), thus minimizing the potential for soft tissue trauma. An acrylic connecting bar was used in all of the cases, enabling connection of pins that were not in the same plane. All of the fractures healed uneventfully. This report shows that unilateral ESF with an acrylic connecting bar, combined with an I.M pin, is an effective method for the repair of a wide variety of tibial fractures.

Keywords

Acrylic connecting bar - tibia - unilateral ESF (Type l-a) - I.M pin
 

  • References

  • 1 Anderson MA, Palmer RH, Aron DN. Improving pin selection and insertion technique for external skeletal fixation. Compend Contin Ed 1997; 19: 485-94.
    PubMedGoogle Scholar
  • 2 Aron DN, Foutz TL, Keller WG, Brown J. Experimental and clinical experience with an IM pin external skeletal Fixator tie-in configuration. Vet Comp Orthop Traumatol 1991; 04: 86-94.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Aron DN, Dewey CW. Application and postoperative management of external skeletal fixators. Vet Clin North Am Small Anim Pract 1992; 22: 69-97.
    CrossrefPubMedGoogle Scholar
  • 4 Aron DN, Johnson AL, Palmer RH. Biologic strategies and a balanced concept for repair of highly comminuted long bone fractures. Comp Cont Ed 1995; 17: 35-49.
    PubMedGoogle Scholar
  • 5 Aron D. Practical techniques for fractures. In: Current Techniques In Small Animal Surgery. Bojrab J. 1998. 04 934-41.
    Google Scholar
  • 6 Behrens F, Searls K. External fixation of the tibia. Basic concepts and postoperative evaluation. J Bone Joint Surgery 1986; 68-B: 246-54.
    PubMedGoogle Scholar
  • 7 Boone EG, Johnson AL, Montavon P. Fractures of the tibial diaphysis in dogs and cats. J Am Vet Med Ass 1986; 188: 316-20.
    PubMedGoogle Scholar
  • 8 Bouvy BM, Markel MD, Sudhakar C, Egger EL, Piermattei DL, Vanderby R. Ex vivo biomechanics of Kirschner-Ehmer external skeletal fixation applied to canine tibiae. Vet Surg 1993; 22: 194-207.
    CrossrefPubMedGoogle Scholar
  • 9 Denny HR, Butterworth SJ. Options in fracture management. In: A Guide to Canine and Feline Orthopedic Surgery. Denny HR, Butterworth SJ. 2000. 04 97-109.
    Google Scholar
  • 10 Dixon BC, Tomlinson JL, Wagner-Mann CC. Effects of three intramedullary pinning techniques on proximal pin location and articular damage in the canine tibia. Vet Surg 1994; 23: 448-55.
    CrossrefPubMedGoogle Scholar
  • 11 Dewey CW, Aron DN, Foutz TL, Marks MA, Budsberg SC. Static strength evaluation of two modified unilateral external fixators. J Small Animal Pract 1994; 35: 211-6.
    CrossrefPubMedGoogle Scholar
  • 12 Egger EL. Static strength evaluation of six external skeletal fixation configurations. Vet Surg 1983; 12: 130-6.
    CrossrefPubMedGoogle Scholar
  • 13 Egger EL, Rigg DL, Blass CE. et al. Type I biplanar configuration of external skeletal fixation Application technique in nine dogs and one cat. J Am Vet Med Ass 1985; 187: 262-7.
    PubMedGoogle Scholar
  • 14 Egger EL, Runyon CL, Rigg DL. Use of the type I double connecting bar configuration of external skeletal fixation on long bone fractures in dogs: A review of 10 cases. J Am Anim Hosp Assoc 1986; 22: 57-64.
    PubMedGoogle Scholar
  • 15 Egger EL, Histand MB, Blass CE. Effect of fixation pin insertion on the pin-bone interface. Vet Surg 1986; 15: 246-52.
    CrossrefPubMedGoogle Scholar
  • 16 Egger EL. Complications of external fixation. In: Fracture complications. Vet Clin North Am Small Anim Pract 1991; 21: 705-33.
    CrossrefPubMedGoogle Scholar
  • 17 Emmerson TD, Muir P. Bone plate removal in dogs and cats. Vet Comp Orthop Traumatol 1999; 02: 74-7.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 18 Foland MA, Schwarz PD, Salman MD. The adjunctive use of half-pin (type 1) external skeletal fixators in combination with intramedullary pins for femoral fractures fixation. Vet Comp Orthop Traumatol 1991; 04: 77-85.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Foland MA, Egger EL. Application of type 3 external fixators: A review of 23 clinical fractures in 20 dogs and two cats. J Am Anim Hosp Assoc 1991; 27: 193-202.
    PubMedGoogle Scholar
  • 20 Font J, Franch J, Cairo J. A review of 116 clinical cases treated with external fixators. Vet Comp Orthop Traumatol 1997; 10: 173-82.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Green SA. Complications of external skeletal fixation. Clin Orthop 1983; 180: 109-16.
    PubMedGoogle Scholar
  • 22 Harari J. Complications of external skeletal fixation. In: External Skeletal Fixation. Vet Clin North Am Small Anim Pract 1992; 22: 99-109.
    CrossrefPubMedGoogle Scholar
  • 23 Harari J, Bebchuk T, Seguin B, Lincoln J. Closed repair of tibial fractures and radial fractures with external skeletal fixation. Comp Cont Ed 1996; 18: 651-65.
    PubMedGoogle Scholar
  • 24 Hulse DA, Johnson AL. Management of specific fractures. Tibial and fibular fractures. In: Small Animal Surgery. Fossum TW. 1997; 01 868-76.
    PubMedGoogle Scholar
  • 25 Johnson AL, Kneller SK, Weigel RM. Radial and tibial fracture repair with external skeletal fixation effects of fracture type, reduction, and complications on healing. Vet Surg 1989; 18: 367-72.
    CrossrefPubMedGoogle Scholar
  • 26 Johnson AL, Boone EG. Fractures of the tibia and fibula. In: Textbook of Small Animal Surgery vol 2. Slatter D. (eds). W.B. Saunders, Philadelphia: 1993: 1866-76.
    Google Scholar
  • 27 Johnson AL, Seitz SE, Smith CW. et al. Closed reduction and type 2 external fixation of comminuted fractures of the radius and tibia in dogs: 23 cases (1990-1994). J Am Vet Med Ass 1996; 209: 1445-8.
    PubMedGoogle Scholar
  • 28 Kolata RJ. et al. Patterns of trauma in urban dogs and cats: A study of 1000 cases. J Am Vet Med Ass 1974; 164: 499-502.
    PubMedGoogle Scholar
  • 29 Kolata RJ, Johnston DE. Motor vehicle accidents in urban dogs: A study of 600 cases. J Am Vet Med Ass 1975; 167: 938-41.
    PubMedGoogle Scholar
  • 30 Marti JM, Miller A. Delimitation of safe corridors for the insertion of external fixator. J Small Animal Pract 1994; 35: 16-23.
    CrossrefPubMedGoogle Scholar
  • 31 Martinez SA, Arnoczky SP, Flo GL, Brinker WO. Dissipation of heat during polymerization of acrylics used for external skeletal fixator connecting bars. Vet Surg 1997; 26: 290-4.
    CrossrefPubMedGoogle Scholar
  • 32 McCartney W. Use of the modified Acrylic external fixator in 54 dog and 28 cats. Vet Rec 1998; 143: 330-4.
    CrossrefPubMedGoogle Scholar
  • 33 McPherron-Foland MA, Schwarz PD, Histand MB. Mechanical evaluation of half pin (type 1) external skeletal fixation in combination with a single intramedullary pin. Vet Surg 1992; 21: 178-82.
    CrossrefPubMedGoogle Scholar
  • 34 Muir P, Johnson KA, Markel MD. Area moment of inertia for comparison of implant cross sectional geometry and bending moment. Vet Comp Orthop Traumatol 1995; 08: 146-52.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 35 Okrasinsky EB, Pardo AD, Graehler RA. Biomechanical evaluation of acrylic external skeletal fixation in dogs and cats. J Am Vet Med Ass 1991; 199: 1590-3.
    PubMedGoogle Scholar
  • 36 Olivieri M, Suter PF. Compartmental syndrome of the front leg of a dog due to rupture of the median artery. J Am Anim Hosp Assoc 1978; 14: 210-8.
    PubMedGoogle Scholar
  • 37 Paul JP, Barbanel JC. Biomechanics. In: Medical Engineering. Ed C.D. Ray. Year Book Medical Publishers. Chicago: 1974: 199-215.
    Google Scholar
  • 38 Pardo AD. Relationship of tibial intramedullary pins to canine stifle joint structures: A comparison of normograde and retrograde insertion. J Am Anim Hosp Assoc 1994; 30: 369-74.
    PubMedGoogle Scholar
  • 39 Piermattei DL, Flo GL. Fractures of the tibia and the fibula. In: Handbook of Small Animal Orthopedics and Fracture Repair. Piermattei DL, Flo GL. (eds). 3rd. ed. W. B. Saunders, Philadelphia: 1997: 581-606.
    Google Scholar
  • 40 Polio FE, Hyman WA, Hulse DE. The role of the external bar in a 6-pin type 1 external skeletal fixation device. Vet Comp Orthop Traumatol 1993; 06: 75-9.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 41 Ross JT, Matthiesen DT. The use of multiple pin and methylmethacrylate external skeletal fixation for the treatment of orthopedic injuries in the dog and cat. Vet Comp Orthop Traumatol 1993; 06: 115-21.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 42 Shahar R. Relative stiffness and stress of typeland type 2 external fixators: acrylic versus stainless steel connecting bar-theoretical approach. Vet Surg 2000; 29: 59-69.
    CrossrefPubMedGoogle Scholar
  • 43 Shahar R. Evaluation of stiffness and stress of external fixators with curved acrylic connecting bar. Vet Comp Orthop Traumatol 2000; 13: 65-72.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 44 Williams N, Tomlinson JL, Hahn AW, Constantinescue GM, Wagner-Mann CC. Heat conduction of fixator Pins with polymethylmethacrylate external fixation. Vet Comp Orthop Traumatol 1997; 10: 153-9.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 45 Wilier RL, Egger EL, Histand MB. Comparison of stainless steel versus acrylic for the connecting bar of external skeletal fixators. J Am Anim Hosp Assoc 1991; 27: 541-8.
    PubMedGoogle Scholar