title: Why fine-wire fixators work: an analysis of pressure distribution at the wire-bone interface.
abstract: Tensioned fine-wire external fixator systems have been used successfully for the treatment of fractures, mal-unions and for limb lengthening for many years. When used in metaphyseal bone, this type of fixator has a lower loosening rate than half-pin fixators. The differing mechanical properties of these fixator systems have been investigated extensively; however, most studies have centered on the mechanical properties of the fixator as a whole. Our knowledge of the interactions occurring at the interface between implant and bone remains sparse. In order to investigate this interaction, we devised a simple experimental model to characterise the distribution of pressure in cancellous bone surrounding a tensioned wire under loading conditions. Comparison was then made to a similar model of a half-pin fixator. Pressure was measured using pressure sensitive film at various distances away from the implant-bone interface. Static, single cycle loading of the model was performed with a Universal Testing Machine. Pressure distribution in the fine-wire model was found to occur in three regions: polar, beam loading and uniform. Polar patterns were seen closest to the wire with pressure concentrated at the entry and exit points of the wire. Beam loading was seen at a distance of 1.5 mm from the wire and pressure reached a uniform distribution at 4.0 mm. Most of the pressure measured was less than 2 MPa, which is less than the yield strength of cancellous bone (2-7 MPa). Higher loads produced higher stresses but the distribution pattern was similar. In contrast, the half-pin model showed far higher pressures (20 MPa), which were present deeper in the bone specimen. These results further our understanding of the biomechanics of fine-wire fixators and may explain the lower loosening rate of this type of fixator when compared to half-pin fixators used in metaphyseal bone.
authors.affiliation: Manchester University, Oxford Road, Manchester, M13 9PL, UK. boardtim@hotmail.com
authors.forename: T N
authors.initials: TN
authors.lastname: Board
authors.forename: L
authors.initials: L
authors.lastname: Yang
authors.forename: M
authors.initials: M
authors.lastname: Saleh
mesh_terms: D001696:Biomechanical Phenomena; D001864:Bone Wires; D001842:Bone and Bones / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery; D016267:External Fixators; D006801:Humans; D066298:In Vitro Techniques; D008953:Models, Anatomic; D008954:Models, Biological; D011312:Pressure