External Fixator Clamp Reuse Degrades Clamp Mechanical Performance
To determine the effects of clamp reuse for the Kirschner-Ehmer (KE); Securos; and the IMEX-SK clamp. Experimental bench test of mechanical properties. Specially designed fixtures were used to mechanically test 18 clamps of each type with respect to 6 mechanical variables: fixator pin slippage, conn...
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| Published in | Veterinary surgery Vol. 38; no. 4; pp. 530 - 536 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Malden, USA
Malden, USA : Blackwell Publishing Inc
01.06.2009
Blackwell Publishing Inc Blackwell Publishing Ltd |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0161-3499 1532-950X 1532-950X |
| DOI | 10.1111/j.1532-950X.2009.00521.x |
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| Abstract | To determine the effects of clamp reuse for the Kirschner-Ehmer (KE); Securos; and the IMEX-SK clamp. Experimental bench test of mechanical properties. Specially designed fixtures were used to mechanically test 18 clamps of each type with respect to 6 mechanical variables: fixator pin slippage, connecting bar slippage, fixator pin rotation, connecting bar rotation, and clockwise and counterclockwise clamp-bolt axis pivot. Each clamp was tested 6 times for each variable at 7.68 Nm of clamp-bolt tightening torque. Results were compared using repeated measures ANOVA. For the IMEX-SK clamp, a significant degradation in the force required to cause slippage was found for connecting bar slippage and fixator pin rotation; however, this clamp also had a significant increase in the force to initiate slippage for clockwise clamp-bolt axis pivot with reuse. The Securos clamp had significant degradation in connecting bar slippage, connecting bar rotation, and fixator pin rotation whereas the KE clamp had significant degradation in connecting bar slippage only. All 3 external fixator clamp types degraded in 1 or more movement variables in their ability to resist motion with reuse. The IMEX and Securos clamps were more subject to degradation than the KE clamp and this may have clinical importance for fixator composite rigidity. Fracture-reduction stability is related to the ability to resist motion within a clamp. The unpredictable nature of degradation we found cautions against repeated use. Clinicians should consider reuse of external fixator clamps with the knowledge that repeated use degrades clamp mechanical performance. |
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| AbstractList | Objective— To determine the effects of clamp reuse for the Kirschner–Ehmer (KE); Securos; and the IMEX–SK clamp.
Study Design— Experimental bench test of mechanical properties.
Methods— Specially designed fixtures were used to mechanically test 18 clamps of each type with respect to 6 mechanical variables: fixator pin slippage, connecting bar slippage, fixator pin rotation, connecting bar rotation, and clockwise and counterclockwise clamp–bolt axis pivot. Each clamp was tested 6 times for each variable at 7.68 Nm of clamp–bolt tightening torque. Results were compared using repeated measures ANOVA.
Results— For the IMEX–SK clamp, a significant degradation in the force required to cause slippage was found for connecting bar slippage and fixator pin rotation; however, this clamp also had a significant increase in the force to initiate slippage for clockwise clamp–bolt axis pivot with reuse. The Securos clamp had significant degradation in connecting bar slippage, connecting bar rotation, and fixator pin rotation whereas the KE clamp had significant degradation in connecting bar slippage only.
Conclusions— All 3 external fixator clamp types degraded in 1 or more movement variables in their ability to resist motion with reuse. The IMEX and Securos clamps were more subject to degradation than the KE clamp and this may have clinical importance for fixator composite rigidity.
Clinical Relevance— Fracture‐reduction stability is related to the ability to resist motion within a clamp. The unpredictable nature of degradation we found cautions against repeated use. Clinicians should consider reuse of external fixator clamps with the knowledge that repeated use degrades clamp mechanical performance. To determine the effects of clamp reuse for the Kirschner-Ehmer (KE); Securos; and the IMEX-SK clamp. Experimental bench test of mechanical properties. Specially designed fixtures were used to mechanically test 18 clamps of each type with respect to 6 mechanical variables: fixator pin slippage, connecting bar slippage, fixator pin rotation, connecting bar rotation, and clockwise and counterclockwise clamp-bolt axis pivot. Each clamp was tested 6 times for each variable at 7.68 Nm of clamp-bolt tightening torque. Results were compared using repeated measures ANOVA. For the IMEX-SK clamp, a significant degradation in the force required to cause slippage was found for connecting bar slippage and fixator pin rotation; however, this clamp also had a significant increase in the force to initiate slippage for clockwise clamp-bolt axis pivot with reuse. The Securos clamp had significant degradation in connecting bar slippage, connecting bar rotation, and fixator pin rotation whereas the KE clamp had significant degradation in connecting bar slippage only. All 3 external fixator clamp types degraded in 1 or more movement variables in their ability to resist motion with reuse. The IMEX and Securos clamps were more subject to degradation than the KE clamp and this may have clinical importance for fixator composite rigidity. Fracture-reduction stability is related to the ability to resist motion within a clamp. The unpredictable nature of degradation we found cautions against repeated use. Clinicians should consider reuse of external fixator clamps with the knowledge that repeated use degrades clamp mechanical performance. To determine the effects of clamp reuse for the Kirschner-Ehmer (KE); Securos; and the IMEX-SK clamp. Experimental bench test of mechanical properties. Specially designed fixtures were used to mechanically test 18 clamps of each type with respect to 6 mechanical variables: fixator pin slippage, connecting bar slippage, fixator pin rotation, connecting bar rotation, and clockwise and counterclockwise clamp-bolt axis pivot. Each clamp was tested 6 times for each variable at 7.68 Nm of clamp-bolt tightening torque. were compared using repeated measures ANOVA. Results- For the IMEX-SK clamp, a significant degradation in the force required to cause slippage was found for connecting bar slippage and fixator pin rotation; however, this clamp also had a significant increase in the force to initiate slippage for clockwise clamp-bolt axis pivot with reuse. The Securos clamp had significant degradation in connecting bar slippage, connecting bar rotation, and fixator pin rotation whereas the KE clamp had significant degradation in connecting bar slippage only. All 3 external fixator clamp types degraded in 1 or more movement variables in their ability to resist motion with reuse. The IMEX and Securos clamps were more subject to degradation than the KE clamp and this may have clinical importance for fixator composite rigidity. Fracture-reduction stability is related to the ability to resist motion within a clamp. The unpredictable nature of degradation we found cautions against repeated use. Clinicians should consider reuse of external fixator clamps with the knowledge that repeated use degrades clamp mechanical performance. To determine the effects of clamp reuse for the Kirschner-Ehmer (KE); Securos; and the IMEX-SK clamp.OBJECTIVETo determine the effects of clamp reuse for the Kirschner-Ehmer (KE); Securos; and the IMEX-SK clamp.Experimental bench test of mechanical properties.STUDY DESIGNExperimental bench test of mechanical properties.Specially designed fixtures were used to mechanically test 18 clamps of each type with respect to 6 mechanical variables: fixator pin slippage, connecting bar slippage, fixator pin rotation, connecting bar rotation, and clockwise and counterclockwise clamp-bolt axis pivot. Each clamp was tested 6 times for each variable at 7.68 Nm of clamp-bolt tightening torque.METHODSSpecially designed fixtures were used to mechanically test 18 clamps of each type with respect to 6 mechanical variables: fixator pin slippage, connecting bar slippage, fixator pin rotation, connecting bar rotation, and clockwise and counterclockwise clamp-bolt axis pivot. Each clamp was tested 6 times for each variable at 7.68 Nm of clamp-bolt tightening torque.were compared using repeated measures ANOVA. Results- For the IMEX-SK clamp, a significant degradation in the force required to cause slippage was found for connecting bar slippage and fixator pin rotation; however, this clamp also had a significant increase in the force to initiate slippage for clockwise clamp-bolt axis pivot with reuse. The Securos clamp had significant degradation in connecting bar slippage, connecting bar rotation, and fixator pin rotation whereas the KE clamp had significant degradation in connecting bar slippage only.RESULTSwere compared using repeated measures ANOVA. Results- For the IMEX-SK clamp, a significant degradation in the force required to cause slippage was found for connecting bar slippage and fixator pin rotation; however, this clamp also had a significant increase in the force to initiate slippage for clockwise clamp-bolt axis pivot with reuse. The Securos clamp had significant degradation in connecting bar slippage, connecting bar rotation, and fixator pin rotation whereas the KE clamp had significant degradation in connecting bar slippage only.All 3 external fixator clamp types degraded in 1 or more movement variables in their ability to resist motion with reuse. The IMEX and Securos clamps were more subject to degradation than the KE clamp and this may have clinical importance for fixator composite rigidity.CONCLUSIONSAll 3 external fixator clamp types degraded in 1 or more movement variables in their ability to resist motion with reuse. The IMEX and Securos clamps were more subject to degradation than the KE clamp and this may have clinical importance for fixator composite rigidity.Fracture-reduction stability is related to the ability to resist motion within a clamp. The unpredictable nature of degradation we found cautions against repeated use. Clinicians should consider reuse of external fixator clamps with the knowledge that repeated use degrades clamp mechanical performance.CLINICAL RELEVANCEFracture-reduction stability is related to the ability to resist motion within a clamp. The unpredictable nature of degradation we found cautions against repeated use. Clinicians should consider reuse of external fixator clamps with the knowledge that repeated use degrades clamp mechanical performance. Objective— To determine the effects of clamp reuse for the Kirschner–Ehmer (KE); Securos; and the IMEX–SK clamp. Study Design— Experimental bench test of mechanical properties. Methods— Specially designed fixtures were used to mechanically test 18 clamps of each type with respect to 6 mechanical variables: fixator pin slippage, connecting bar slippage, fixator pin rotation, connecting bar rotation, and clockwise and counterclockwise clamp–bolt axis pivot. Each clamp was tested 6 times for each variable at 7.68 Nm of clamp–bolt tightening torque. Results were compared using repeated measures ANOVA. Results— For the IMEX–SK clamp, a significant degradation in the force required to cause slippage was found for connecting bar slippage and fixator pin rotation; however, this clamp also had a significant increase in the force to initiate slippage for clockwise clamp–bolt axis pivot with reuse. The Securos clamp had significant degradation in connecting bar slippage, connecting bar rotation, and fixator pin rotation whereas the KE clamp had significant degradation in connecting bar slippage only. Conclusions— All 3 external fixator clamp types degraded in 1 or more movement variables in their ability to resist motion with reuse. The IMEX and Securos clamps were more subject to degradation than the KE clamp and this may have clinical importance for fixator composite rigidity. Clinical Relevance— Fracture‐reduction stability is related to the ability to resist motion within a clamp. The unpredictable nature of degradation we found cautions against repeated use. Clinicians should consider reuse of external fixator clamps with the knowledge that repeated use degrades clamp mechanical performance. Objective--To determine the effects of clamp reuse for the Kirschner-Ehmer (KE); Securos; and the IMEX-SK clamp. Study Design--Experimental bench test of mechanical properties. Methods--Specially designed fixtures were used to mechanically test 18 clamps of each type with respect to 6 mechanical variables: fixator pin slippage, connecting bar slippage, fixator pin rotation, connecting bar rotation, and clockwise and counterclockwise clamp-bolt axis pivot. Each clamp was tested 6 times for each variable at 7.68 Nm of clamp-bolt tightening torque. Results were compared using repeated measures ANOVA. Results--For the IMEX-SK clamp, a significant degradation in the force required to cause slippage was found for connecting bar slippage and fixator pin rotation; however, this clamp also had a significant increase in the force to initiate slippage for clockwise clamp-bolt axis pivot with reuse. The Securos clamp had significant degradation in connecting bar slippage, connecting bar rotation, and fixator pin rotation whereas the KE clamp had significant degradation in connecting bar slippage only. Conclusions--All 3 external fixator clamp types degraded in 1 or more movement variables in their ability to resist motion with reuse. The IMEX and Securos clamps were more subject to degradation than the KE clamp and this may have clinical importance for fixator composite rigidity. Clinical Relevance--Fracture-reduction stability is related to the ability to resist motion within a clamp. The unpredictable nature of degradation we found cautions against repeated use. Clinicians should consider reuse of external fixator clamps with the knowledge that repeated use degrades clamp mechanical performance. [PUBLICATION ABSTRACT] |
| Author | KAPATKIN, AMY S. GILLEY, ROBERT S. BEASON, DAVID P. RADIN, ALEX SOSLOWSKY, LOUIS J. SNYDER, DAVID M. SMITH, GAIL K. BOSTON, RAYMOND C. |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/19538676$$D View this record in MEDLINE/PubMed |
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| Notes | http://dx.doi.org/10.1111/j.1532-950X.2009.00521.x istex:3D513384C430BA8C75803C5F3A8546DB39F941F7 ArticleID:VSU00521 ark:/67375/WNG-MPZXP2H5-8 Funded by a Departmental Research Grant provided by the Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania. Presented in part at the 31st Annual Conference of the Veterinary Orthopedic Society in Big Sky, MN, February 22–27, 2004. Dr. Kapatkin's current address is the Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California—Davis, Davis, CA. SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 14 ObjectType-Article-1 ObjectType-Feature-2 content type line 23 Dr. Kapatkin’s current address is the University of California-Davis, Department of Surgical & Radiological Sciences, School of Veterinary Medicine, Davis, CA. |
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| References | Anderson MA, Mann FA, Wagner-Mann C, et al: A comparison of nonthreaded, enhanced threaded, and Ellis fixation pins used in type I external skeletal fixators in dogs. Vet Surg 22:482-489, 1993 Aro HT, Hein TJ, Chao EYS: Mechanical performance of pin clamps in external fixators. Clin Orthop Rel Res 248:246-253, 1989 Palmer RH, Hulse DA, Hyman WA, et al: Principles of bone healing and biomechanics of external skeletal fixation. Vet Clin North Am 22:45-68, 1992 Bouvy BM, Markel MD, Chelikani S, et al: Ex vivo biomechanics of Kirschner-Ehmer external skeletal fixation applied to canine tibiae. Vet Surg 22:194-207, 1993 Egger EL, Histand MB, Blass CE, et al: Effect of pin insertion on the bone-pin interface. Vet Surg 15:246-252, 1986 Kraus KH, Wotton HM, Rand WM: Mechanical comparison of two external fixator clamp designs. Vet Surg 27:224-230, 1998 Egger EL: Static strength evaluation of six external fixation configurations. Vet Surg 12:130-136, 1983 Brinker WO, Verstraete MC, Soutas-Little RW: Stiffness studies of various configurations and type of external fixators. J Am Anim Hosp Assoc 21:801-808, 1985 Bennett RA, Egger EL, Histand M, et al: Comparison of the strength and holding power of 4 pin designs for use with half pin (type I) external skeletal fixation. Vet Surg 16:207-211, 1987 Kraus KH, Wotton HM: Effect of clamp type on type II external fixator stiffness. Vet Comp Orthop Traumatol 12:178-182, 1999 Wosar MA, Marcellin-Little DJ, Roe SC: Influence of bolt tightening torque, wire size, and component reuse on wire fixation in circular external fixation. Vet Surg 31:571-576, 2002 Dernell WS, Harari J, Blackketter DM: A comparison of acute pull-out strength between two-way and one-way transfixation pin insertion for external skeletal fixation in canine bone. Vet Surg 22:110-114, 1993 Gilley RS, Bourgeault C, Wallace LJ, et al: A comparative mechanical study of three external fixator clamps. Vet Surg 30:341-350, 2001 Anderson MA, Mann FA, Kinden DA, et al: Evaluation of cortical bone damage and axial holding power of nonthreaded and enhanced threaded pins placed with and without drilling of a pilot hole in femurs from canine cadavers. J Am Vet Med Assoc 208:883-887, 1996 1998; 27 1996; 208 1989; 248 2002; 31 1993; 22 1986; 15 1998 1999; 12 1992; 22 1985; 21 2001; 30 1987; 16 1983; 12 Brinker WO (e_1_2_6_6_2) 1985; 21 Aro HT (e_1_2_6_16_2) 1989; 248 Anderson MA (e_1_2_6_3_2) 1996; 208 ASTM Designation F1747‐96 (e_1_2_6_14_2) 1998 e_1_2_6_8_2 e_1_2_6_7_2 e_1_2_6_9_2 e_1_2_6_4_2 e_1_2_6_5_2 e_1_2_6_12_2 Kraus KH (e_1_2_6_11_2) 1999; 12 e_1_2_6_13_2 e_1_2_6_2_2 e_1_2_6_10_2 e_1_2_6_15_2 |
| References_xml | – reference: Bennett RA, Egger EL, Histand M, et al: Comparison of the strength and holding power of 4 pin designs for use with half pin (type I) external skeletal fixation. Vet Surg 16:207-211, 1987 – reference: Wosar MA, Marcellin-Little DJ, Roe SC: Influence of bolt tightening torque, wire size, and component reuse on wire fixation in circular external fixation. Vet Surg 31:571-576, 2002 – reference: Gilley RS, Bourgeault C, Wallace LJ, et al: A comparative mechanical study of three external fixator clamps. Vet Surg 30:341-350, 2001 – reference: Brinker WO, Verstraete MC, Soutas-Little RW: Stiffness studies of various configurations and type of external fixators. J Am Anim Hosp Assoc 21:801-808, 1985 – reference: Kraus KH, Wotton HM: Effect of clamp type on type II external fixator stiffness. Vet Comp Orthop Traumatol 12:178-182, 1999 – reference: Egger EL, Histand MB, Blass CE, et al: Effect of pin insertion on the bone-pin interface. Vet Surg 15:246-252, 1986 – reference: Palmer RH, Hulse DA, Hyman WA, et al: Principles of bone healing and biomechanics of external skeletal fixation. Vet Clin North Am 22:45-68, 1992 – reference: Bouvy BM, Markel MD, Chelikani S, et al: Ex vivo biomechanics of Kirschner-Ehmer external skeletal fixation applied to canine tibiae. Vet Surg 22:194-207, 1993 – reference: Kraus KH, Wotton HM, Rand WM: Mechanical comparison of two external fixator clamp designs. Vet Surg 27:224-230, 1998 – reference: Dernell WS, Harari J, Blackketter DM: A comparison of acute pull-out strength between two-way and one-way transfixation pin insertion for external skeletal fixation in canine bone. Vet Surg 22:110-114, 1993 – reference: Anderson MA, Mann FA, Kinden DA, et al: Evaluation of cortical bone damage and axial holding power of nonthreaded and enhanced threaded pins placed with and without drilling of a pilot hole in femurs from canine cadavers. J Am Vet Med Assoc 208:883-887, 1996 – reference: Egger EL: Static strength evaluation of six external fixation configurations. Vet Surg 12:130-136, 1983 – reference: Anderson MA, Mann FA, Wagner-Mann C, et al: A comparison of nonthreaded, enhanced threaded, and Ellis fixation pins used in type I external skeletal fixators in dogs. Vet Surg 22:482-489, 1993 – reference: Aro HT, Hein TJ, Chao EYS: Mechanical performance of pin clamps in external fixators. 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| Snippet | To determine the effects of clamp reuse for the Kirschner-Ehmer (KE); Securos; and the IMEX-SK clamp. Experimental bench test of mechanical properties.... Objective— To determine the effects of clamp reuse for the Kirschner–Ehmer (KE); Securos; and the IMEX–SK clamp. Study Design— Experimental bench test of... Objective— To determine the effects of clamp reuse for the Kirschner–Ehmer (KE); Securos; and the IMEX–SK clamp. Study Design— Experimental bench test of... To determine the effects of clamp reuse for the Kirschner-Ehmer (KE); Securos; and the IMEX-SK clamp. Experimental bench test of mechanical properties.... Objective--To determine the effects of clamp reuse for the Kirschner-Ehmer (KE); Securos; and the IMEX-SK clamp. Study Design--Experimental bench test of... To determine the effects of clamp reuse for the Kirschner-Ehmer (KE); Securos; and the IMEX-SK clamp.OBJECTIVETo determine the effects of clamp reuse for the... |
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| SubjectTerms | Animals Biomechanics clamp reuse Equipment Design Equipment Design - veterinary Equipment Failure Equipment Failure - veterinary external fixator clamp External Fixators External Fixators - veterinary fracture fixation Fracture Fixation - instrumentation Fracture Fixation - veterinary Fractures Fractures, Bone Fractures, Bone - surgery Fractures, Bone - veterinary IMEX-SK clamp instrumentation Kirschner-Ehmer mechanical properties Medical equipment Securos Stress, Mechanical surgery surgical equipment veterinary Veterinary services Wound healing |
| Title | External Fixator Clamp Reuse Degrades Clamp Mechanical Performance |
| URI | https://api.istex.fr/ark:/67375/WNG-MPZXP2H5-8/fulltext.pdf https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fj.1532-950X.2009.00521.x https://www.ncbi.nlm.nih.gov/pubmed/19538676 https://www.proquest.com/docview/215610381 https://www.proquest.com/docview/46315645 https://www.proquest.com/docview/67401044 https://pubmed.ncbi.nlm.nih.gov/PMC7906035 https://www.ncbi.nlm.nih.gov/pmc/articles/7906035 |
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