Do axial dynamic fixators really produce axial dynamization?

The use of dynamic external fixators for the treatment of long bone fracture is widespread and well accepted. It is claimed that dynamization, i.e. small micromovements of compression/distraction at the fracture site, can be produced by allowing sliding of an inner rod within an outer housing. However, as the forces on the fixator are not direct but transferred from the bone via bone pins, there is a bending moment on the fixator. This produces "self-locking" and effectively prevents axial movements. We have studied the effect of this moment on the binding properties of the Orthofix system. The amount of movement at a simulated fracture site allowed before this locking occurs was measured and its implications discussed. It would appear that true axial dynamization does not take place using this system.

[1]  J L Cunningham,et al.  Tibial external fixation, weight bearing, and fracture movement. , 1993, Clinical orthopaedics and related research.

[2]  J. Kenwright,et al.  The influence of external fixators on fracture motion during simulated walking. , 1996, Medical engineering & physics.

[3]  J. Kenwright,et al.  Dynamic Interfragmentary Motion in Fractures During Routine Patient Activity , 1997, Clinical orthopaedics and related research.

[4]  G. Bastiani,et al.  The treatment of fractures with a dynamic axial fixator. , 1984, The Journal of bone and joint surgery. British volume.