title: The impact of the type of derotation mechanism on the stiffness of the Ilizarov fixator.
abstract: One of the applications of the Ilizarov apparatus is the correction of rotational deformities. There are several types of designs commonly used for derotation. Different types of derotators have different mechanical properties, which affect the stability of the entire Ilizarov apparatus. The aim of this study was to determine the stiffness of the Ilizarov fixator depending on the type of derotation mechanism. We analyse three types of derotators: the type Z, the type H, and the cubicoid derotator. The tests were conducted on physical models in which the fixator analysed was fitted to polyethylene pipe segments. The reference fixator was the Ilizarov apparatus in the configuration adapted for thigh lengthening. The pipe segments intersected at a point corresponding to the osteotomy site of the distal thigh. The fixator was assembled with one proximal arch fixed with two Schanz screws, a proximal ring fixed with two Kirschner wires (K-wires), a middle free ring, and a distal ring fixed with three K-wires. There were three different types of derotation mechanisms installed between the proximal and middle rings. We determined the axial stiffness kA and the transverse stiffnesses of the compared fixators in two planes: frontal kM-L and sagittal kA-P. The results of the research lead to two basic conclusions. Firstly, the use of any of the derotators analysed has no negative impact on the stiffness of the Ilizarov apparatus. Secondly, similar stiffness values of the fixators with different derotation mechanisms suggest their equal applicability and the choice between them can be made based on practical considerations. In the case of axial stiffness, the differences do not exceed 7.5%. The highest value of stiffness kA was obtained for the type H derotator, while the lowest value was obtained for the type Z derotator. There is a greater difference in the case of transverse stiffness in the sagittal plane, which only concerns the fixator with the type Z derotators. The stiffness coefficient kA-P for that fixator is lower by approximately 19% compared to the reference fixator.
authors: Department and Clinic of Orthopaedic and Traumatologic Surgery, Wrocław Medical University, Poland. morasp@wp.pl
authors: Piotr
authors: P
authors: Morasiewicz
authors: Jarosław
authors: J
authors: Filipiak
authors: Marcin
authors: M
authors: Konietzko
authors: Szymon
authors: S
authors: Dragan
mesh_terms: D001696:Biomechanical Phenomena / Q000502:physiology; D016267:External Fixators; D005269:Femur; D006801:Humans; D018889:Ilizarov Technique / Q000295:instrumentation*; D012015:Reference Standards; D012399:Rotation