Abstract
Background
We recently developed an algorithm to perform closed fracture reduction using unilateral
external fixator. Although its validity has been verified experimentally, the whole
reduction process was not evaluated owing to the lack of a device that could facilitate
its implementation in clinical practice. The objective of this study is to develop
a prototype of such a system, and quantify its reduction accuracy.
Methods
The system consists of a custom-made unilateral external device and a self-contained
software package. The device features 7 one degree of freedom joints, each allows
for continuous adjustments and is equipped with measurement components to facilitate
accurate positioning. A CT-based method was developed, which facilitates virtual reduction
and calculates the adjustment requirements that reduce a fracture deformity. The device
was adjusted off-the-site and reattached back in place to guide the reduction of the
fracture fragments. Reduction accuracy was evaluated using eight phantoms of different
types, sides and fracture patterns by calculating the rotation about a screw axis
and the displacement between the origins of the distal and proximal local coordinate
systems after the reduction.
Findings
The mean (SD) of the translational and rotational reduction errors were 1.73 (0.97) mm and 2.57° (1.36°), respectively, which demonstrated the accuracy and reliability
of the system.
Interpretation
The system allows surgeons to perform fracture reduction in an objective, efficient,
and accurate manner yet minimize the radiation exposure and lessens the extent of
tissue disruption around the fracture site during the reduction process.
Keywords
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Article info
Publication history
Published online: June 22, 2007
Accepted:
May 8,
2007
Received:
December 8,
2006
Identification
Copyright
© 2007 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
