Finite element analysis of the stability of tibiofibular fractures treated with various combinations of external fixators.

Abstract

Background: External fixators have been extensively applied in the treatment of open tibiofibular fractures and have yielded positive outcomes. The stability of an external fixator primarily hinges on its structure. Employing additional external fixation components can undoubtedly enhance stability. However, there is scant research on the topic of achieving superior stability with fewer external fixation components.

Methods: Utilizing 3D modeling software, constructed three different external fixation models in middle tibial fractures in Group A, constructed four external fixation models in proximal tibial fractures in Group B, and constructed four external fixation models in distal tibial fractures in Group C.Simulate the load under the assistance of a walker to stand up, obtain the displacement of fractures and the stress of the external fixator for each group. Analyze and compare the results of each model.

Results: In a mid-tibial fracture, the stability of the crossbar increases by 21% with each 2 cm closer to the tibia. Model B3 achieves superior stability with the use of more fixed clamps and connecting rods in the "H" shaped model. Although the triangular cross-bar structure used in Model B4 is less stable than that of Model B3, it has achieved 83.2% of the stability of Model B3, despite using fewer components. The stability of Model C4 has increased by 73.44% compared to Model C3.

Conclusions: The external fixator should be configured to keep the crossbar as close to the skin as possible. For proximal tibial fractures, to minimize the use of external fixation components, the triangular cross-bar structure of Model B4 can be employed. In the case of distal tibial fractures, while the triangular cross-bar structure of Model C4 offers good stability, the risk of displacement is greater. Therefore, it is advisable to use an H-shaped fixation method with additional external fixation components, such as those found in Model C3.