Mini-apparatus Ilizarov with polymer supports: use in the treatment of finger deformities



Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

External fixation devices are widely used in traumatology and orthopedics. Devices made of radiolucent composite material allow surgeons to accurately assess the bone healing process using radiographs and significantly reduce the weight of the external fixator. Clear visualization is especially important in the treatment of injuries and diseases of the finger joints. Most known mini-devices of external fixation are made of metal. Metal parts of the fixators can significantly obscure the image of bones and joints on radiographs. Some proprietary devices are quite bulky and heavy. A "transparent" and "light" (by weight) alternative to metal external fixators are polymer devices.

An analysis of the treatment of twelve patients aged 15 to 67 years was conducted. The radiolucent mini-Ilizarov device was used for repositioning and fixation of a fracture of the middle phalanx of a finger (1), for gradual elimination of finger deformities associated with Dupuytren's contracture (8), post-traumatic contracture of fingers (2) and "boutonniere" finger deformity in rheumatoid arthritis (1).

In all cases, a modified Ilizarov mini-apparatus with polymer supports was used. The supporting elements were printed on an FDM 3D printer. The supports were printed in the form of arcs similar to the parts from the standard Ilizarov mini-apparatus set. The supports were prepared with a thickness of 4 mm.

The polymer supports withstood standard sterilization and did not lose their strength. During the treatment, the polymer supports also retained the required strength for the entire treatment period.

The use of radiolucent arches has made it easier to control the image of bones and joints when performing radiography.

The Ilizarov mini-apparatus, assembled from polymer arcs, has proven effective in treating patients with finger deformities. This fixator has positive qualities - radiolucency, sufficient strength and lightness. The device with polymer supports can be an alternative and complement to the traditional original mini-Ilizarov device and similar external fixation devices made of metal.

Full Text

Restricted Access

About the authors

Aleksandr S. Zolotov

Far Eastern Federal University, Far Eastern Federal University Medical Center, Vladivostok, Russia

Email: dalexpk@gmail.com
ORCID iD: 0000-0002-0045-9319
SPIN-code: 3925-9025

Dr. Sci. (Medicine), Professor. Far Eastern Federal University, Far Eastern Federal University Medical Center

Russian Federation, 10 Ayaks settlement, Russky Island, Primorsky Krai, Vladivostok, Russia, 690922

Julia Dyachkova

ДВФУ Медицинский комплекс

Author for correspondence.
Email: zoloto.82@list.ru
ORCID iD: 0009-0009-7107-3614
SPIN-code: 1349-6858

MD, Cand. Sci. (Medicine). Far Eastern Federal University Medical Center

Russian Federation, 10 Ayaks settlement, Russky Island, Primorsky Krai, Vladivostok, Russia, 690922

Semen A Azon

Far Eastern Federal University

Email: azon.sa@dvfu.ru
ORCID iD: 0000-0003-3129-1499
SPIN-code: 7608-2465

аssistant of the Department of Nuclear Technologies

Institute of Science-Intensive Technologies and Advanced Materials

Russian Federation

References

  1. Пугачёв А.Н., Наумов В.Г., Взятышев Н.Н., Ширяев А.Н., Тихомирова М.В. Композиционные материалы и возможность их применения в аппаратах профессора Г.А. Илизарова. Гений Ортопедии. 2004. № 3. С. 76-81.
  2. Pougachiov AN, Naumov VG, Vziatyshev NN, Tikhomirova MV. Composition materials and the possibility of their use in the Ilizarov fixators. Genius of Orthopedics. 2004. № 3. P. 76-81. EDN: PGJWHF.
  3. Baidya KP, Ramakrishna S, Rahman M, Ritchie A. Advanced textile composite ring for Ilizarov external fixator system. Proc Inst Mech Eng H. 2001;215(1):11-23. doi: 10.1243/0954411011533490. PMID: 11323979. EDN: YCPPPA.
  4. Xie M, Cao Y, Cai X, Shao Z, Nie K, Xiong L. The Effect of a PEEK Material-Based External Fixator in the Treatment of Distal Radius Fractures with Non-Transarticular External Fixation. Orthop Surg. 2021 Feb;13(1):90-97. doi: 10.1111/os.12837. EDN: RCEBGP.
  5. Bonardi A, Rovesti GL, Martini FM, Dondi F, Benedini D, Barbieri F. Comparison between Areas of Bone Visualization Using Radiolucent Hybrid Fixator Frames and Graphically Simulated Metallic Frames: An Ex Vivo Study. Vet. Sci. 2022, 9, 120. https://doi.org/ 10.3390/vetsci9030120. EDN: CUKXRM.
  6. Оганесян О.В., Шинкаренко И.Н., Абельцев В.П. Восстановление формы и функции кисти и пальцев с помощью аппаратов наружной чрескостной фиксации. Москва Медицина, 1984. 96 с.
  7. Шихалева Н.Г., Щудло Н.А., Данилкин М.Ю. и др. Роль чрескостного остеосинтеза по Г.А. Илизарову в хирургии кисти. Гений ортопедии. 2011. Т. 27, № 2. С. 38-43. EDN: OGCTJJ.
  8. Шевцов В.И., Кириенко А.П., Шихалева Н.Г., Новиков К.И. История мини-фиксатора Илизарова, этапы становления хирургии кисти в Центре Илизарова. Гений ортопедии. 2021. Т. 27, № 3. С. 299-306. doi: 10.18019/1028-4427-2021-27-3-299-306. EDN: YHQZLF.
  9. Shevtsov VI, Kirienko AP, Shikhaleva NG, Novikov KI. History of the Ilizarovs wire-fixator, stages of hand surgery development at the Ilizarov Center. Genius of Orthopedics. 2021. Т. 27, № 3. P. 299-306. doi: 10.18019/1028-4427-2021-27-3-299-306. EDN: YHQZLF.
  10. da Silva PN, Barbosa R, Ferreira P, Ferreira A, Malheiro E, Silva A, Reis J, Amarante J. Correction of long term joint contractures of the hand by distraction. A case report. Br J Plast Surg. 2005 Dec;58(8):1148-51. doi: 10.1016/j.bjps.2005.04.028.
  11. Kodama A, Sunagawa T, Nakashima Y, Shinomiya R, Hayashi Y, Ochi M, Adachi N. Joint distraction and early mobilization using a new dynamic external finger fixator for the treatment of fracture-dislocations of the proximal interphalangeal joint. J Orthop Sci. 2018 Nov;23(6):959-966. doi: 10.1016/j.jos.2018.07.013.
  12. Messina A, Messina J. The TEC treatment (continuous extension technique) for severe Dupuytren's contracture of the fingers. Ann Chir Main Memb Super. 1991;10(3):247-50. doi: 10.1016/s0753-9053(05)80290-x.
  13. Messina JC, Messina A. Indications of the continuous extension technique (TEC) for severe Dupuytren Disease and recurrences. In: Werker PMN, Dias J, Eaton C, Reichert B, Wach W (eds) Dupuytren Disease and Related Diseases – The Cutting Edge. Switzerland, Springer International Publishing, 2017: 311–6.
  14. Skelley NW. Design and Development of a Novel 3-D Printed External Fixation Device for Fracture Stabilization. 3D Print Med. 2023 Jun 14;9(1):17. doi: 10.1186/s41205-023-00179-7.
  15. Danilkin MY. Phalangeal Lengthening Techniques for Brachydactily and Posttraumatic Digital Stumps With the Use of a Modified External Mini-Fixator. Tech Hand Up Extrem Surg. 2016 Jun;20(2):61-6. doi: 10.1097/BTH.0000000000000116. EDN: WWANWZ.
  16. Kataoka T, Kodera N, Takai S. The Ilizarov Mini-External Fixator for the Treatment of First Metatarsal Fracture: A Case Report. J Nippon Med Sch. 2017;84(3):144-147. doi: 10.1272/jnms.84.144.
  17. Tomori Y, Nanno M, Sonoki K, Majima T. Minimally Invasive Corrective Osteotomy with the Ilizarov Mini-Fixator for Malunited Fractures of the Phalanges: Technical Note. J Nippon Med Sch. 2021 Jun 30;88(3):262-266. doi: 10.1272/jnms.JNMS.2021_88-314. Epub 2020 Aug 31. EDN: STSKZV.
  18. Tomori Y, Kodera N, Nanno M, Majima T. Minimal Invasive Corrective Osteotomy with the Ilizarov Mini-Fixator for Malunited Fractures of Proximal Phalanges in Adolescence: Report of Three Cases and a Review of the Literature. J Nippon Med Sch. 2023;90(2):141-148. doi: 10.1272/jnms.JNMS.2023_90-214. EDN: CXLNRV.
  19. Zhu Y, Xu Y, Pu S, Lv Q, Cai X, Zhao Y. Metacarpal Lengthening Using a Mini-Ring Ilizarov Device for Thumb Reconstruction. J Hand Surg Am. 2024 Jul;49(7):708.e1-708.e6. doi: 10.1016/j.jhsa.2022.09.008. EDN: BMOYPT.
  20. Usami S, Sonoki K, Kawahara S. Individual Joint Distractions Using Ilizarov Mini-Fixator Device for Chronic Simultaneous Dislocation of the Distal and Proximal Interphalangeal Joints in the Same Finger. Hand (N Y). 2025 Jun;20(4):NP1-NP4. doi: 10.1177/15589447241279598.
  21. Обухов И.А. Кистевая хирургия: Посттравматические контрактуры пальцев кисти. Монография, T.2. Екатеринбург, ФГБОУ ВО УГМУ Минздрава России, 2016.- 318 с.
  22. Останина Д.А. Особенности клинического течения и результаты комплексного лечения контрактуры Дюпюитрена у мужчин и женщин [Рукопись]: специальность 3.1.8 "Травматология и ортопедия»: автореферат диссертации на соискание ученой степени кандидата медицинских наук; Национальный медицинский исследовательский центр травматологии и ортопедии им. Г. А. Илизарова. Курган, 2024. 25 с. Библиогр.: с. 22-23.
  23. Zolotov AS. Two-stage treatment of severe Dupuytren's contracture with an external fixator. J Hand Surg Eur Vol. 2020 Mar;45(3):301-303. doi: 10.1177/1753193419865716

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) Eco-Vector


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77-76249 от 19.07.2019.