Comparison between Areas of Bone Visualization Using Radiolucent Hybrid Fixator Frames and Graphically Simulated Metallic Frames: An Ex Vivo Study.

Andrea Bonardi,Davide Benedini,Gian Luca Rovesti,Filippo Maria Martini,Francesco Dondi,Fabio Barbieri

doi:10.3390/vetsci9030120

Andrea Bonardi, Davide Benedini + Show 4 more

Open Access

https://doi.org/10.3390/vetsci9030120

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Journal: Veterinary sciences	Publication Date: Mar 7, 2022
Citations: 1	License type: CC BY 4.0

Affiliation: University of Parma, University of Bologna

Abstract

The objective of this study is to evaluate the difference between the amount of bone visible with the superimposition of a radiolucent hybrid external fixator and a graphically simulated metallic frame. Eighteen frames were applied to eighteen bone specimens. The fracture area (FA), the radiolucent area (RLA) and the radiopaque area (ROA) inside the FA were calculated for each construct on both postoperative views. The ratio between the RLA and FA and between the ROA and FA was used to evaluate the amount of bone visible in the FA with a radiolucent and a radiopaque fixator, respectively. Finally, the areas of RLA and ROA were compared using the Wilcoxon test and Friedman test to evaluate the effect of the radiolucent material on the amount of bone visible. Differences were considered significant if p < 0.5. In every specimen p was <0.5. The amount of bone visible was significantly higher with the radiolucent frame compared to the radiopaque frame. Based on the results of this study, the use of radiolucent materials can be a valuable option for external fixation, in order to decrease the radiographic interference of the frame, allowing better assessment of fracture reduction and bone healing on postoperative radiographs.

Highlights

The circular (CEF) and hybrid (HEF) external skeletal fixation have been shown to be effective treatment modalities for fracture stabilization, for performing bone transport, limb lengthening and for the correction of angular and rotational limb deformities [1,2].CEF and HEF both require limited surgical exposure and minimize disruption of the blood supply to bone and soft tissues [1,3]
The objective of this study is to evaluate the difference between the amount of bone visible with the superimposition of a radiolucent hybrid external fixator and a graphically simulated metallic frame
Based on the results of this study, the use of radiolucent materials can be a valuable option for external fixation, in order to decrease the radiographic interference of the frame, allowing better assessment of fracture reduction and bone healing on postoperative radiographs

Summary

Introduction

CEF and HEF both require limited surgical exposure and minimize disruption of the blood supply to bone and soft tissues [1,3]. They are useful for stabilizing highly comminuted fractures that cannot be anatomically reconstructed, while facilitating the management of associated soft tissue injuries. One of the most important limitations associated with the use of external fixation is the radiographic interference due to the superimposition of the frame on the bone segment. This is true with the use of CEFs that completely surround the limb. This can cause a difficult PO evaluation of fracture healing, requiring multiple radiographic projections, often oblique, which increase the exposure for both the patient and the personnel with poor repeatability that makes the comparison between different projections difficult [9,10]

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