A biomechanical study of a novel multi axial circular external fixation device for stabilization of a bovine cadaveric tibial fracture gap model

Document Type : Full paper (Original article)

Authors

1 Ph.D. Student in Veterinary Surgery and Radiology, Division of Surgery, Indian Veterinary Research Institute, Izzathnagar, Bareilly, Uttar Pradesh, India

2 Division of Veterinary Surgery and Radiology, Indian Veterinary Research Institute, Izzathnagar, Bareilly, Uttar Pradesh, India

3 AMIE Mechanical Engineering, Design Lab, Indian Institute of Technology, School of Mechanical and Material Engineering, Mandi, Himachal Pradesh, India

Abstract

Background: Circular external fixators are widely used in orthopaedic fracture management but often face limitations in complex fractures due to their rigid structure. The multi axial circular external fixator offers increased flexibility and adjustability, making it a promising alternative for cases involving anatomical variability. Aims: The present study aimed to compare the biomechanical properties, including stiffness and strength, of a novel multi-axial circular fixator (MCEF) with a traditional full-ring circular external fixator (CEF) using buffalo tibia fracture model. Methods: The study used eighteen buffalo tibiae divided into three groups: intact bones, CEF, and MCEF constructs. Each construct was subjected to axial compression and torsion tests. The constructs were subjected to loads until failure, and load-displacement curves were generated for each sample. Axial compression and torsion tests were performed to evaluate the biomechanical performance of both fixators. Mechanical parameters such as stress, stiffness, yield load, resilience energy, failure load, and maximum torque were measured and analysed. Appropriate statistical tests were performed to compare between groups. Results: CEF demonstrated higher stiffness in axial compression and bending as compared with MCEF, which showed greater flexibility under both axial and torsional loads. MCEF, however, provided enhanced multi-planar adaptability, making it better suited for fractures in anatomically variable regions. In torsion, CEF exhibited higher maximum torque and torsional strength. Conclusion: CEF provided greater axial and bending stiffness. The MCEF design allows flexibility and adaptability providing better optimization of fracture stabilization in complex fracture patterns, making it a viable alternative in large animal fracture management.

Keywords

Main Subjects

References

Adams, SB (1985). The role of external fixation and emergency fracture management in bovine orthopaedics. Vet. Clin. North Am. Food Anim. Pract., 1: 109-129.
Aithal, HP; Amarpal and Kinjavdekar, P (2007). Transarticular fixation using a circular external fixator for management of fractures near the carpal joint in two calves. Vet. Rec., 161: 193-198.
Aithal, HP; Kinjavdekar, P; Amarpal, M; Pawde, AM; Singh, GR and Setia, HC (2010a). Management of tibial fractures using a circular external fixator in two calves. Vet. Surg., 39: 621-626.
Aithal, HP; Kinjavdekar, P; Pawde, AM; Dubey, P; Kumar, R; Tyagi, SK and Madhu, DN (2019). Epoxy-Pin external skeletal fixation for management of open bone fractures in calves and foals: A review of 32 cases. Vet. Comp. Orthop. Traumatol., 32: 257-268.
Aithal, HP; Singh, GR; Hoque, M; Maiti, SK; Kinjavdekar, P; Amarpal; Pawde, AM and Setia, HC (2004). The use of circular external skeletal fixation device for the management of long bone osteotomies in large ruminants: An experimental study. J. Vet. Med., 51: 284-293.
Aithal, HP; Singh, GR; Saxena, RK; Kinjavdekar, P; Amarpal, A; Pawde, AM; Hoque, M and Maiti, SK (2010b). Comparative mechanical, chemical, and microstructural properties of mild steel and aluminum rings used in large animal circular external fixators. Indian J. Anim. Sci., 80: 428-430.
Anderson, DE and St Jean, G (1996). External skeletal fixation in ruminants. Vet. Clin. North Am. Food Anim. Pract., 12: 117-152.
Bowers, KM and Anderson, DE (2024). Delayed union and nonunion: current concepts, prevention, and correction: a review. Bioengineering. 11: 1-19.
Bronson, DG; Samchukov, ML; Birch, JG; Browne, RH and Ashman, RB (1998). Stability of external circular fixation: A multi-variable biomechanical analysis. Clin. Biomech., 13: 441-448.
Calhoun, JH; Li, F; Ledbetter, BR and Gill, CA (1992). Biomechanics of Ilizarov fixator for fracture fixation. Clin. Orthop. Relat. Res., 280: 15-22.
Cervantes, C; Madison, JB; Miller, GJ and Casar, RS (1996). An in-vitro biomechanical study of a multiplanar circular external fixator applied to equine third metacarpal bones. Vet. Surg., 25: 1-5.
Dubey, P; Aithal, HP; Kinjavdekar, P; Amarpal, GP and Nanjappa, MD (2021). A comparative in vitro biomechanical investigation of a novel bilateral linear fixator vs. circular and multiplanar epoxy-pin external fixation systems using a fracture model in buffalo metacarpal bone. World J. Surg. Surg. Res., 4: 1-9.
Egol, KA; Kubiak, EN; Fulkerson, E; Kummer, FJ and Koval, KJ (2004). Biomechanics of locked plates and screws. J. Orthop. Trauma. 18: 488-493.
Ferretti, A (1991). The application of the Ilizarov technique to veterinary medicine. In: Bianchi-Maiocchi, A and Aronson, J (Eds.), Operative principles of Ilizarov. (1st Edn.), Milan, Italy: Medi. Surgical Vido., PP: 551-570.
Fleming, B; Paley, D; Kristiansen, T and Pope, M (1989). A biomechanical analysis of the Ilizarov external fixator. Clin. Orthop. Relat. Res., 241: 95-105.
Gasser, B; Boman, B; Wyder, D and Schneider, E (1989). Stiffness characteristics of the circular Ilizarov device as opposed to conventional external fixation. J. Biomech. Eng., 112: 15-21.
Gasser, B; Boman, B; Wyder, D and Schneider, E (1990). Stiffness characteristics of the circular Ilizarov device as opposed to conventional external fixation. J. Biomech. Eng., 112: 15-21.
Lewis, DD; Bronson, DG; Samchukov, ML; Welch, RD and Stallings, JT (1998). Biomechanics of circular external skeletal fixation. Vet. Surg., 27: 454-464.
Lewis, DD; Cross, AR; Carmichael, S and Anderson, MA (2001). Recent advances in external skeletal fixation. J. Small Anim. Pract., 42: 103-112.
Lewis, DD; Radasch, RM; Beale, BS; Stallings, JT; Lanz, OI; Welch, RD and Samchukov, ML (1999). Initial clinical experience with the IMEX TM circular external skeletal fixation system. Part I: Use in fractures and arthrodeses. Vet. Comp. Orthop. Traumatol., 12: 108-117.
Marcellin-Little, DJ (1999). Fracture treatment with circular external fixation. Vet. Clin. North Am. Small Anim. Pract., 29: 1153-1170.
Mitousoudis, AS; Magnissalis, EA and Kourkoulis, SK (2010). A biomechanical analysis of the Ilizarov external fixator. EPJ Web Conf., 6: 21002.
Moss, DP and Tejwani, NC (2007). Biomechanics of external fixation. Bull. NYU Hosp. Jt. Dis., 65: 294-299.
Paley, D (1991). Biomechanics of the Ilizarov external fixator. In: Bianchi-Maiocchi, A and Aronson, J (Eds.), Operative principles of Ilizarov. (1st Edn.), Milan, Italy: Medi Surgical Vido., PP: 33-41.
Paul, JP and Barbenel, JC (1974). Biomechanics. In: Ray, CD (Ed.), Medical engineering. (1st Edn.), Chicago, IL: Year Book Medical Publishers. PP: 199-215.
Podolsky, A and Chao, EYS (1993). Mechanical performance of Ilizarov circular external fixators in comparison with other external fixators. Clin. Orthop. Relat. Res., 293: 61-70.
Rapoff, AJ; Markel, MD and Vanderby, R (1995). Mechanical evaluation of transosseous wire rope configurations in a large animal external fixator. Am. J. Vet. Res., 56: 694-699.
Rubin, CT and Lanyon, LE (1984). Regulation of bone formation by applied dynamic loads. J. Bone Joint Surg. Am., 66: 397-402.
Sarpel, Y; Gulsen, M; Togrul, E; Capa, M and Herdem, M (2005). Comparison of mechanical performance among different frame configurations of the Ilizarov external fixator: experimental study. J. Trauma Acute Care Surg., 58: 546-552.
Schneider, RK; Milne, DW; Gabel, AA; Groom, JJ and Bramlage, LR (1982). Multidirectional in vitro strain analysis of the equine radius and tibia during dynamic loading with and without a cast. Am. J. Vet. Res., 43: 1541-1550.
Shah, MA (2019). Circular and hybrid external skeletal fixation systems for tibial fracture repair in large ruminants: Biomechanical and clinical study. Doctoral Dissertation, IVRI, Izatnagar. PP: 1-166.
Shi, D; Liu, K; Zhang, H; Wang, X; Li, G and Zheng, L
(2020). Investigating the biomechanical function of the plate-type external fixator in the treatment of tibial fractures: a biomechanical study. BMC Musculoskelet. Disord., 21: 1-9.
Singh, GR; Aithal, HP; Saxena, RK; Kinjavdekar, P; Amarpal, M; Hoque, M; Maiti, SK; Pawde, AM and Joshi, HC (2007). In-vitro biomechanical properties of linear, circular, and hybrid external skeletal fixation devices developed for use in large ruminants. Vet. Surg., 36: 80-87.
Snedecor, GW and Cochran, WG (1994). Statistical methods. (8th Edn.), Ames, IA: Iowa State University Press. PP: 1-503.
Steiner, A and Anderson, DE (2009). Fracture management in cattle. In: Anderson, DE (Ed.), Fracture management in cattle. (2nd Edn.), St. Louis, Missouri, USA, Saunders Elsevier. PP: 253-258.
Steiner, A; Iselin, U; Auer, J and Lischer, CJ (1993). Shaft fractures of the metacarpus and metatarsus in cattle. Vet. Comp. Orthop. Traumatol., 6: 138-145.
Tan, BB; Shanmugam, R; Gunalan, R; Chua, YP; Hossain, G and Saw, A (2014). A biomechanical comparison between Taylor’s spatial frame and Ilizarov external fixator. Malays. Orthop. J., 8: 35-39.
Widanage, KN; De Silva, MJ; Lalitharatne, TD; Bull, AM and Gopura, RARC (2023). Developments in circular external fixators: A review. Injury. 54: 1-16.
Wu, JJ; Shyr, HS; Chao, EYS and Kelly, PJ (1984). Comparison of osteotomy healing under external fixation devices with different stiffness characteristics. J. Bone Joint Surg. Am., 66: 1258-1264.
Yilmaz, E; Belhan, O; Karakurt, L; Arslan, N and Serin, E (2003). Mechanical performance of hybrid Ilizarov external fixator in comparison with Ilizarov circular external fixator. Clin. Biomech., 18: 518-522.

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