An investigation was conducted to determine what improvements in the resistance to slippage could be obtained in selected interfaces (rod/clip torsional, cheek/bowl and cheek/clip) of the Hoffmann external fixator. The modification involved changing the standard wing-nut clamp for a bolt with a thread of 7 mm and a 1 mm pitch and placing an FAG 28-303 thrust-bearing (needle roller and cage assembly) between the bolt and the cheek. The results showed a significant improvement in the slippage values of all interfaces; increases of approximately six times were obtained at all torque values of the wing-nut clamp or fastener tested. Such improvements would markedly increase the reliability of external fixation systems and thus reduce the incidence of loss-of-reduction of fracture due to slippage of the universal joint.
Hoffmann half-frame external fixation device configurations often fail under minimal loads secondary to joint slippage. In these experiments improved universal joints that were developed in an earlier study were tested on Hoffmann half-frame assemblies. The rigidity of selected half-frame configurations was tested in four modes (axial compression, torsion, medial-lateral and anterior-posterior four-point bending). These results were compared to those of an earlier, similar study looking at the standard Hoffmann half-frame. No changes in overall rigidity were noted, but significant increases in yield loads and loads to frame failure were achieved. Such improvements will increase the reliability and usefulness of the Hoffmann device to the orthopaedic community.
For tibial fractures, half-frames, such as the Hoffmann fixation device, sometimes fail when subjected to weight-bearing loads. Because the joints of the Hoffmann system are known to slip, which could lead to frame failure, three interfaces of the standard Hoffmann joint were tested at different clamp torques and different rates of load application. No difference in mean slippage values was noted for any interface at similar clamp torques. Joint slippage and any subsequent frame failure are thus not related to rate of load application, but to the magnitude of the load alone.
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