Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-28T06:56:34.554Z Has data issue: false hasContentIssue false

Kinematic Study of an Innovative Dynamic Bridging Wrist External Fixator with Arthrodiatasis

Published online by Cambridge University Press:  05 May 2011

K.-S. Shih*
Affiliation:
Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan 10617, R. O. C. Division of Orthopedic Surgery, Department of Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan 22060, R.O.C. Institute of Mechanical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan 10607, R.O.C.
S.-C. Lin*
Affiliation:
Institute of Biomedical Engineering, National Central University, Taoyuan, Taiwan 32001, R.O.C. Department of Mechanical Engineering, National Central University, Taoyuan, Taiwan 32001, R.O.C.
Y.-H. Liu*
Affiliation:
Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan 10617, R.O.C.
T.-H. Chang*
Affiliation:
Institute of Mechanical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan 10607, R.O.C.
S.-M. Hou*
Affiliation:
Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan 10617, R.O.C. Department of Orthopedic Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan 11101, R.O.C.
T.-W. Lu*
Affiliation:
Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan 10617, R.O.C.
*
* M.D.
** Ph.D.
*** M.SC.
*** M.SC.
**** M.D., Ph.D., corresponding author
***** Ph.D
Get access

Abstract

External wrist fixators have been widely used to stabilize distal radial fractures. Ideally an external fixator would create a stable environment for the fracture to heal while allowing proper mobility for the wrist. However, this has been a great challenge to the designers.

The current study aimed to develop a bridging wrist external fixator that is easy for surgeons to create a stable environment for the fracture to heal while allowing proper wrist mobility for rehabilitative purposes. The kinematic geometry of the wrist-fixator system was described using loop equations defined by homogeneous transformation matrices (HTM) of the joints involved, and was evaluated numerically for a set of system parameters that are determined by surgeons during surgery. The results were validated with geometric models and computer simulation. The contributions of individual clinical parameters to the kinematic geometry of the wrist-fixator system were also analyzed using the Taguchi method.

Adequate pin placement and hinge alignment function were found to be critical for the postoperative bridged wrist motion. The results of the current study will be helpful for surgeons to perform fixation using the new wrist fixator and for designers to design new fixators in the future.

Type
Articles
Copyright
Copyright © The Society of Theoretical and Applied Mechanics, R.O.C. 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Ark, J. and Jupiter, J. B., “The Rationale for Precise Management of Distal Radius Fractures,” Orthopedic Clinics of North America, 24, pp. 205210 (1993).CrossRefGoogle Scholar
2.Agee, J. M., “External Fixation, Technical Advances Based upon Multiplanar Ligamentotaxis,” Orthopedic Clinics of North America, 24, pp. 265274 (1993).CrossRefGoogle Scholar
3.Cooney, W. P., “External Fixation of Distal Radial Fractures,” Clinical Orthopaedics and Related Research, 180, pp. 4449 (1983).Google Scholar
4.Nakata, R. Y., Chand, Y. and Matiko, J. D., “External Fixators for Wrist Fractures: A Biomechanical and Clinical Study,” Journal of Hand Surgery, 10, pp. 845851 (1985).CrossRefGoogle Scholar
5.Clyburn, T. A., “Dynamic External Fixation for Comminuted Intra-Articular Fractures of the Distal End of the Radius,” Journal of Bone and Joint Surgery, 69, pp. 248254 (1987).CrossRefGoogle Scholar
6.Leung, K. S., So, W. S., Chiu, V. D. and Leung, P. C., “Ligamentotaxis for Comminuted Distal Fracture Modified by Primary Cancellous Grafting and Functional Bracing: Long-Term Results,” Journal of Orthopaedic Trauma, 5, pp. 265271 (1991).CrossRefGoogle Scholar
7.Abe, Y., Doi, K., Kuwata, N., Yamamoto, H., Sunago, K. and Kawai, S., “Surgical Options for Distal Radial Fractures: Indications and Limitations,” Archives of Orthopaedic and Trauma Surgery, 117, pp. 188192 (1998).CrossRefGoogle Scholar
8.Krishnan, J., Chipchase, L. S. and Slavotinek, J., “Intraarticular Fractures of the Distal Radius Treated with Metaphseal External Fixation, Early Clinical Results,” Journal of Hand Surgery, British, 23, pp. 396399 (1998).CrossRefGoogle Scholar
9.Rockwood, C. A., Green, D. P., Bucholz, R. W. and Heckman, J. D., “Fractures in Adults, Lippincott-Raven,“ Philadelphia, pp. 229259 (1996).Google Scholar
10.McQueen, M., “Redisplaced Unstable Fractures of the Distal Radius: A Randomised, Prospective Study of Bridging Versus Non-Bridging External Fixation,” Journal of Bone Joint Surgery, British, 80–B, pp. 665669 (1998).CrossRefGoogle Scholar
11.Franck, W. M., Dahlen, C., Amlang, M., Friese, F. and Zwipp, H., “Distal Radius Fracture–Is Non-bridging Articular External Fixator a Therapeutic Alternative? A Prospective Randomized Study,” Unfallchirurg, 103, pp. 826833 (2000).Google Scholar
12.Shih, K.-S., Lu, T.-W., Fu, Y.-C., Hou, S.-M., Sun, J.-S. and Cheng, C.-Y., “Biomechanical Analysis of Nonconstrained and Semiconstrained Total Elbow Replacement: A Preliminary Report,” Journal of Mechanics, 24, pp. 103110(2008)CrossRefGoogle Scholar
13.Youm, Y. and Mcmurtry, R. Y., “Kinematics of the Wrist,“ The Journal of Bone and Joint Surgery, American Volume, 4, pp. 423431 (1978).Google Scholar