Strategies in Trauma and Limb Reconstruction

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VOLUME 15 , ISSUE 3 ( September-December, 2020 ) > List of Articles

Original Article

Reducing the Risk of Ring Breakage in Taylor Spatial Frames: The Effect of Frame Configuration on Strain at the Half-ring Junction

Alexios D Iliadis, Roland Bebja, Katherine Wang, Mehran Moazen, Jonathan Wright, Peter Calder, David Goodier

Keywords : Circular external fixator, Complication, Deformity correction, Taylor spatial frame

Citation Information : Iliadis AD, Bebja R, Wang K, Moazen M, Wright J, Calder P, Goodier D. Reducing the Risk of Ring Breakage in Taylor Spatial Frames: The Effect of Frame Configuration on Strain at the Half-ring Junction. 2020; 15 (3):146-150.

DOI: 10.5005/jp-journals-10080-1508

License: CC BY-NC-SA 4.0

Published Online: 00-12-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: We have encountered four cases with Taylor spatial frames (TSF) (Smith & Nephew, Memphis, TN, USA) with breakage at the half-ring junction of the distal ring. This study examines the strain produced on different locations of the distal ring during loading and the effects on the strain of altering the frame construct. Materials and methods: We mounted two ring TSF constructs on tibia saw bone models. The proximal ring was the same in all constructs and consisted of a 2/3 180 mm ring attached with three wires. Construct 1 is reproducing the configuration of cases where failure was seen. The distal 155 mm ring is attached with three half pins. The half-ring junction is located in the midline. Construct 2 has a different half pin placement and an additional wire on the distal ring. Constructs 3 and 4 have the same half pin configuration to construct 1 but the distal ring is rotated 60° internally and externally, respectively. Strain gauges were attached to different locations and measurements recorded during loading. Statistical analysis was performed. Results: Highest strain values were recorded at the half-ring junction of constructs 1 and 2 (>600 microstrains (με) in tension). Rotating the ring 60° internally significantly reduces the strain at the half-ring junction (<300 με) whilst external rotation by 60° further reduces the strain (<180 με). Ring strain is higher in areas close to half pin attachments. Conclusions: The highest strain is in the half-ring junction as the half rings are subjected to different loading modes. The thickness of the half-ring is halved and the second moment of area reduced further increasing breakage risk. Placing this junction close to the half pin–frame interface, as dictated by the anatomical safe zone further increases the strain. Rotating the distal ring 60° significantly reduces the strain at the half-ring junction. Clinical significance: Ring breakage is a rare but significant complication. This is the first study to address this potential mode of TSF failure. Insights and technical tips from this study can help reduce this.


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