Mechanical Evaluation of Various External Skeletal Fixator–Intramedullary Pin Tie-in Configurations Using a Tubular Plastic Bone Model

Abstract Use of external skeletal fixator–intramedullary pin tie-in (ESF-IM pin tie-in) fixators is an adjustable and effective method of fracture fixation in birds. The objective of this study was to evaluate the elements of the ESF-IM tie-in configuration used in birds. Ten variations of constructs were applied to a plastic bone model with a standard gap. Variants included non-tied and tie-in configurations, use of a 6- or 10-mm acrylic bar or a thermoplastic connecting bar, variation in the placement of the proximal fixation pin, use of 1.1-mm (0.045-in) or 1.6-mm (0.062-in) fixation pins, and configurations of 2, 3, or 4 fixation pins. The various constructs were loaded in bending, torque, and compression, and response variables were determined from resulting load-displacement curves (stiffness, load at 1-mm displacement). Results showed that, by using the tie-in configuration, increasing the diameter of the acrylic connecting bar, and increasing the diameter or number of fixation pins, each significantly increased the stiffness in all assessments. Placing the fixation pin distally in the proximal bone model segment increased the stiffness in bending, and adding a fixation pin to the distal bone model segment increased the stiffness in torque and bending. These results quantified the relative importance of specific parameters that effect stiffness and safe load of the ESF-IM tie-in construct as applied to a plastic bone fracture model.