International Peer-Reviewed JournalOpen AccessISSN 2456-8880
irejournals@gmail.com+91-7433024337

Home / Current Issue / Paper 1708792

1708792 Vol 8 · Issue 11 Download Paper

Systematic Review of the Evolvement of External Bone Fracture Fixators

E. A. Dinesh Kumara

Subject area: Science,Engineering and Technology  ·  Area of research: Bone Fracture Fixators

Abstract

External fixation is a method of stabilizing fractures which employs pins which are connected to the bone at one end, travel through the surrounding soft tissues, and are fixed to a rigid external metal or composite frame. In readiness for conclusive treatment through internal fixing, current fracture care routinely requires the use of external fixation to maintain initial fracture stabilization with limited adverse effects on the soft tissues. As a result of the use of these external instruments, procedures of bone regeneration continue to progress in large part. In this study, with a focus on unilateral and circular frames, external fixators, and their evolution from the first fixators to the current fixators are studied.

Keywords

Orthopaedic surgery research, External fixators, Bone fractures

References

[1] D. Lowenberg, M. Githens and C. Boone, "Principles of Tibial Fracture Management with Circular External Fixation", Orthopedic Clinics of North America, vol. 45, no. 2, pp. 191-206, 2014. Available: 10.1016/j.ocl.2013.11.003.

[2] A. Fragomen and S. Rozbruch, "The Mechanics of External Fixation", HSS Journal, vol. 3, no. 1, pp. 13-29, 2006. Available: 10.1007/s11420-006-9025-0.

[3] V. Glatt, C. Evans and K. Tetsworth, "A Concert between Biology and Biomechanics: The Influence of the Mechanical Environment on Bone Healing", Frontiers in Physiology, vol. 7, 2017. Available: 10.3389/fphys.2016.00678 [Accessed 20 December 2020].

[4] A. Zamani-Farahani, "Analysis of TSF and Ilizarov Ring Fixators in Orthopaedics by Finite Element Modelling and Mechanical Testing", PhD,University of Manchester - Faculty of Engineering and Physical Sciences, 2015.

[5] T. Oliveira Ramos, On the treatment of tibial fractures using the Ilizarov fixator. Göteborg: Department of Orthopaedics, Institute of Clincial Sciences at Sahlgrenska Academy, University of Gothenburg, 2014.

[6] P. John Hillard, "Aspects of the Biomechanics of Ilizarov External Fixation", PhD, University of Bristol - Department of Mechanical Engineering, 1999.

[7] F. von Knoch, J. Marsh, C. Steyers, T. McKinley, M. O’Rourke and M. Bottlang, "A NEW ARTICULATED ELBOW EXTERNAL FIXATION TECHNIQUE FOR DIFFICULT ELBOW TRAUMA", The Iowa Orthopaedic Journal, vol. 21, p. 13, 2020. [Accessed 21 December 2020].

[8] S. Brown, I. Lasrado and L. Donnan, "Peri-acetabular external fixation for hip disease: an anatomical study", Strategies in Trauma and Limb Reconstruction, vol. 2, no. 2-3, pp. 69-75, 2007. Available: 10.1007/s11751-007-0019-3 [Accessed 22 December 2020].

[9] J. Gross, B. Gavanier, R. Belleville, H. Coudane and D. Mainard, "Advantages of external hybrid fixators for treating Schatzker V-VI tibial plateau fractures: A retrospective study of 40 cases", Orthopaedics & Traumatology: Surgery & Research, vol. 103, no. 6, pp. 965-970, 2017. Available: 10.1016/j.otsr.2017.05.023 [Accessed 22 December 2020].

[10] R. Littlewood, The Benefits and Risks of the Ilizarov Technique for Limb Reconstruction. Semantic Scholar, 2011, pp. 1-4.

[11] P. Pairon, C. Ossendorf, S. Kuhn, A. Hofmann and P. Rommens, "Intramedullary nailing after external fixation of the femur and tibia: a review of advantages and limits", European Journal of Trauma and Emergency Surgery, vol. 41, no. 1, pp. 25-38, 2014. Available: 10.1007/s00068-014-0448-x [Accessed 23 December 2020].

[12] A. Fragomen and S. Rozbruch, "The Mechanics of External Fixation", HSS Journal, vol. 3, no. 1, pp. 13-29, 2006. Available: 10.1007/s11420-006-9025-0 [Accessed 23 December 2020].

[13] M. Swiontkowski and W. Cross III, "Treatment principles in the management of open fractures", Indian Journal of Orthopaedics, vol. 42, no. 4, p. 377, 2008. Available: 10.4103/0019-5413.43373 [Accessed 23 December 2020].

[14] S. Mkize and Ν. Ferreira, "Outcome of bilateral circular fixators in complex lower limb fractures", 2020.

[15] A. Lerner, H. Stein and E. Calif, "Unilateral Hinged External Fixation Frame for Elbow Compression Arthrodesis: The Stepwise Attainment of a Stable 90-Degree Flexion Position", Journal of Orthopaedic Trauma, vol. 19, no. 1, pp. 52-55, 2005. Available: 10.1097/00005131-200501000-00010.

[16] C. Şen, Y. Sağlam, M. Kocaoğlu, F. Bilen and H. Balci, "Limb Lengthening", Basic Techniques for Extremity Reconstruction, pp. 645-681, 2018. Available: 10.1007/978-3-319-45675-1_41 [Accessed 23 December 2020].

[17] B. Spiegelberg, T. Parratt, S. Dheerendra, W. Khan, R. Jennings and D. Marsh, "Ilizarov principles of deformity correction", The Annals of The Royal College of Surgeons of England, vol. 92, no. 2, pp. 101-105, 2010. Available: 10.1308/003588410x12518836439326 [Accessed 23 December 2020].

[18] B. Spiegelberg, T. Parratt, S. Dheerendra, W. Khan, R. Jennings and D. Marsh, "Ilizarov principles of deformity correction", The Annals of The Royal College of Surgeons of England, vol. 92, no. 2, pp. 101-105, 2010. Available: 10.1308/003588410x12518836439326 [Accessed 23 December 2020].

[19] A. Gubin, D. Borzunov and T. Malkova, "The Ilizarov paradigm: thirty years with the Ilizarov method, current concerns and future research", International Orthopaedics, vol. 37, no. 8, pp. 1533-1539, 2013. Available: 10.1007/s00264-013-1935-0 [Accessed 23 December 2020].

[20] D. Stamer, R. Schenk, B. Staggers, K. Aurori, B. Aurori and F. Behrens, "Bicondylar Tibial Plateau Fractures Treated with a Hybrid Ring External Fixator: A Preliminary Study", Journal of Orthopaedic Trauma, vol. 8, no. 6, pp. 455-461, 1994. Available: 10.1097/00005131-199412000-00001.

[21] P. Calder, D. Goodier, A. Iliadis, P. Jaiswal, J. Meswania and G. Blunn, "Stability at the half pin–frame interface on external fixation constructs", Strategies in Trauma and Limb Reconstruction, vol. 11, no. 3, pp. 193-198, 2016. Available: 10.1007/s11751-016-0269-z [Accessed 23 December 2020].

[22] K. Kouassi, O. Cartiaux, L. Fonkoué, C. Detrembleur and O. Cornu, "Biomechanical study of a low-cost external fixator for diaphyseal fractures of long bones", Journal of Orthopaedic Surgery and Research, vol. 15, no. 1, 2020. Available: 10.1186/s13018-020-01777-5 [Accessed 23 December 2020].

[23] A. Raza, S. Kumar, D. Kumar, A. Qadir, M. Muzzammil and M. Lakho, "Complex Tibial Plateau Fractures: Primary Fixation Using the Ilizarov External Fixator. A Two-year Study at Civil Hospital Karachi, Pakistan", Cureus, 2019. Available: 10.7759/cureus.5375 [Accessed 23 December 2020].

[24] A. Aslan, E. Uysal and A. Özmeriç, "A Staged Surgical Treatment Outcome of Type 3 Open Tibial Fractures", ISRN Orthopedics, vol. 2014, pp. 1-7, 2014. Available: 10.1155/2014/721041 [Accessed 24 December 2020].

[25] J. Sun, Q. Li, F. Gao, Z. Xiang, Q. Huang and L. Li, "Application of the Ilizarov technique for knee joint arthrodesis as a treatment for end-stage tuberculosis of the knee", BMC Musculoskeletal Disorders, vol. 21, no. 1, 2020. Available: 10.1186/s12891-020-03603-9 [Accessed 24 December 2020].

[26] A. Martins Amaro, M. Fátima Paulino, L. Manuel Roseiro and M. Augusta Neto, "The Effect of External Fixator Configurations on the Dynamic Compression Load: An Experimental and Numerical Study", Applied Sciences, vol. 10, no. 1, p. 3, 2019. Available: 10.3390/app10010003 [Accessed 24 December 2020].

[27] H. Singh, "Management of Proximal Tibia Fractures Using Wire Based Circular External Fixator", JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2015. Available: 10.7860/jcdr/2015/15626.6513 [Accessed 24 December 2020].

[28] V. Glatt, C. Evans and K. Tetsworth, "A Concert between Biology and Biomechanics: The Influence of the Mechanical Environment on Bone Healing", Frontiers in Physiology, vol. 7, 2017. Available: 10.3389/fphys.2016.00678 [Accessed 24 December 2020].

[29] D. Shi, K. Liu, H. Zhang, X. Wang, G. Li and L. Zheng, "Investigating the biomechanical function of the plate-type external fixator in the treatment of tibial fractures: a biomechanical study", BMC Musculoskeletal Disorders, vol. 21, no. 1, 2020. Available: 10.1186/s12891-020-3144-5 [Accessed 24 December 2020].

[30] D. Haroon Chohan, D. Lal, D. Bux Chachar, D. Baig, D. Kumar and D. Khoso, "ILIZAROV TECHNIQUES; TO STUDY THE RESULTS OF INFECTED NONUNION OF TIBIA", THE PROFESSIONAL MEDICAL JOURNAL, vol. 23, no. 06, pp. 709-714, 2016. Available: 10.17957/tpmj/16.3225 [Accessed 24 December 2020].

[31] A. Gubin, D. Borzunov, L. Marchenkova, T. Malkova and I. Smirnova, "Contribution of G.A. Ilizarov to bone reconstruction: historical achievements and state of the art", Strategies in Trauma and Limb Reconstruction, vol. 11, no. 3, pp. 145-152, 2016. Available: 10.1007/s11751-016-0261-7 [Accessed 24 December 2020].

[32] W. Smith et al., "Treatment of traumatic forearm bone loss with Ilizarov ring fixation and bone transport", International Orthopaedics, vol. 31, no. 2, pp. 165-170, 2006. Available: 10.1007/s00264-006-0172-1 [Accessed 24 December 2020].

[33] Z. Hao, Y. Xia, D. Xia, Y. Zhang and S. Xu, "Treatment of open tibial diaphyseal fractures by external fixation combined with limited internal fixation versus simple external fixation: a retrospective cohort study", BMC Musculoskeletal Disorders, vol. 20, no. 1, 2019. Available: 10.1186/s12891-019-2679-9 [Accessed 24 December 2020].

[34] S. Arora, S. Batra, V. Gupta and A. Goyal, "Distraction Osteogenesis Using a Monolateral External Fixator for Infected Non-Union of the Femur with Bone Loss", Journal of Orthopaedic Surgery, vol. 20, no. 2, pp. 185-190, 2012. Available: 10.1177/230949901202000210 [Accessed 24 December 2020].

[35] "External fixation of complex tibial fractures: the design rationale and biomechanical testing of a new hybrid external fixator", Injury, vol. 29, no. 2, p. 155, 1998. Available: 10.1016/s0020-1383(98)00018-7.

[36] "Abstract Book - 93rd National Congress of the Italian Society of Orthopaedics and Traumatology", Journal of Orthopaedics and Traumatology, vol. 9, no. 1, pp. 1-94, 2008. Available: 10.1007/s10195-008-0030-6 [Accessed 24 December 2020].

[37] H. Fattah Mohamed, "External Fixator as Primary and Definitive Treatment of Closed Diaphyseal Lower Limb Fractures in Children", Orthopedics and Rheumatology Open Access Journal, vol. 7, no. 3, 2017. Available: 10.19080/oroaj.2017.07.555713 [Accessed 24 December 2020].

[38] M. Taljanovic, M. Jones, J. Ruth, J. Benjamin, J. Sheppard and T. Hunter, "Fracture Fixation", RadioGraphics, vol. 23, no. 6, pp. 1569-1590, 2003. Available: 10.1148/rg.236035159 [Accessed 24 December 2020].

[39] J. Ristiniemi, "External fixation of tibial pilon fractures and fracture healing", Acta Orthopaedica, vol. 78, no. 326, pp. 2-34, 2007. Available: 10.1080/17453690610046521 [Accessed 24 December 2020].

[40] E. Vasiliadis, T. Grivas, S. Psarakis, E. Papavasileiou, A. Kaspiris and G. Triantafyllopoulos, "Advantages of the Ilizarov external fixation in the management of intra-articular fractures of the distal tibia", Journal of Orthopaedic Surgery and Research, vol. 4, no. 1, 2009. Available: 10.1186/1749-799x-4-35 [Accessed 24 December 2020].

[41] M. Hanif Ramlee and A. Derus, "The use of external fixator for ankle and foot injuries management-a review on biomechanical perspective", Medical Devices and Diagnostic Engineering, vol. 1, no. 1, 2016. Available: 10.15761/mdde.1000102 [Accessed 24 December 2020].

[42] B. MM, "Distraction Osteogenesis by Ilizarov Technique for Infected Gap Non-Union of the Femur", MOJ Orthopedics & Rheumatology, vol. 6, no. 2, 2016. Available: 10.15406/mojor.2016.06.00212.

[43] Z. Zhang, W. Swanson, Y. Wang, W. Lin and G. Wang, "Infection-free rates and Sequelae predict factors in bone transportation for infected tibia: a systematic review and meta-analysis", BMC Musculoskeletal Disorders, vol. 19, no. 1, 2018. Available: 10.1186/s12891-018-2363-5 [Accessed 24 December 2020].

[44] M. Voor, V. Antoci, B. Kam and C. Roberts, "Hybrid External Fixation of Proximal Tibia Fractures: Biomechanical Analysis of Four Commercial Systems", Orthopedics, vol. 30, no. 12, pp. 1033-1038, 2007. Available: 10.3928/01477447-20071201-06 [Accessed 24 December 2020].

[45] D. Höntzsch, P. Trafton and R. Buckley, "Uniplanar external fixator for Simple fracture, spiral", Surgeryreference.aofoundation.org, 2020. [Online]. Available: https://surgeryreference.aofoundation.org/orthopedic-trauma/adult-trauma/tibial-shaft/simple-fracture-spiral/uniplanar-external-fixator. [Accessed: 24- Dec- 2020].

[46] 2020. [Online]. Available: https://www.researchgate.net/figure/Ring-external-fixators-a-the-parallel-ring-fixator-with-three-longitudinal-rods_fig3_334756105. [Accessed: 24- Dec- 2020].

[47] D. Höntzsch, P. Trafton and R. Buckley, "Uniplanar external fixator for Simple fracture, spiral", Surgeryreference.aofoundation.org, 2020. [Online]. Available: https://surgeryreference.aofoundation.org/orthopedic-trauma/adult-trauma/tibial-shaft/simple-fracture-spiral/uniplanar-external-fixator. [Accessed: 24- Dec- 2020].

[48] R. White, M. Camuso and P. Trafton, "Ring fixator (Ilizarov) for Simple fracture, oblique", Surgeryreference.aofoundation.org, 2020. [Online]. Available: https://surgeryreference.aofoundation.org/orthopedic-trauma/adult-trauma/tibial-shaft/simple-fracture-oblique/ring-fixator-ilizarov. [Accessed: 24- Dec- 2020].

[49] "Fijador Externo – AOMedical", Aomedical.com.mx, 2020. [Online]. Available: http://www.aomedical.com.mx/etiqueta-producto/fijador-externo/?orderby=price. [Accessed: 24- Dec- 2020].

[50] "TST R. Medical Devices,Human external fixation system / modular Ilizarov TST R. Medical Devices", HealthManagement.org, 2020. [Online]. Available: https://healthmanagement.org/products/view/human-external-fixation-system-modular-ilizarov-tst-r-medical-devices. [Accessed: 24- Dec- 2020].

[51] Healio.com, 2020. [Online]. Available: https://www.healio.com/orthopedics/trauma/journals/ortho/2007-12-30-12/%7B381298a7-f1d6-4675-b93a-47ebd9b0ba0c%7D/hybrid-external-fixation-of-proximal-tibia-fractures-biomechanical-analysis-of-four-commercial-systems. [Accessed: 24- Dec- 2020].

How to cite this paper

E. A. Dinesh Kumara "Systematic Review of the Evolvement of External Bone Fracture Fixators" Iconic Research And Engineering Journals Volume 8 Issue 11 2025 Page 2162-2174
E. A. Dinesh Kumara "Systematic Review of the Evolvement of External Bone Fracture Fixators" Iconic Research And Engineering Journals, vol. 8, no. 11, May. 2025
E. A. Dinesh Kumara (2025). Systematic Review of the Evolvement of External Bone Fracture Fixators. Iconic Research And Engineering Journals, 8(11).
E. A. Dinesh Kumara "Systematic Review of the Evolvement of External Bone Fracture Fixators" Iconic Research And Engineering Journals, vol. 8, no. 11, May. 2025.
@article{1708792,
      author = {E. A. Dinesh Kumara},
      title = {Systematic Review of the Evolvement of External Bone Fracture Fixators},
      journal = {Iconic Research And Engineering Journals},
      year = {2025},
      volume = {8},
      number = {11},
      pages = {2162-2174},
      issn = {2456-8880},
      url = {https://www.irejournals.com/formatedpaper/1708792.pdf},
      abstract = {External fixation is a method of stabilizing fractures which employs pins which are connected to the bone at one end, travel through the surrounding soft tissues, and are fixed to a rigid external metal or composite frame. In readiness for conclusive treatment through internal fixing, current fracture care routinely requires the use of external fixation to maintain initial fracture stabilization with limited adverse effects on the soft tissues. As a result of the use of these external instruments, procedures of bone regeneration continue to progress in large part. In this study, with a focus on unilateral and circular frames, external fixators, and their evolution from the first fixators to the current fixators are studied.},
      keywords = {Orthopaedic surgery research, External fixators, Bone fractures},
      month = {May},
  }