title: Stimulation of bone union with dynamic beams of Konzal's "R" external fixator.
abstract: BACKGROUND
  Treatment of septic long bone non-union remains a complex therapeutic problem. External stabilisation with Konzal's "R" fixator has been used in the Orthopaedic Department of CPME for years and allows for rigid stabilisation of bone fragments and good mutual alignment. Tried and tested in the treatment of osteitis, the fixator, however, offers limited possibilities for dynamisation and interfragmental compression. The following article presents a modernised design of Konzal's "R" with dynamic beams.
  
  
  METHODS
  The efficacy of dynamisation of the fixator with the modernised design was compared with that of the earlier technique of eccentric shifting of static beams by assessing the time of bone union, the average number of pin restabilisations required, and the percentage of "partial unions" in two groups treated with the different methods.
  
  
  RESULTS
  In the dynamic beam group, mean time to bone union was shorter by 5.1 months on average. This group also recorded a significantly lower percentage of "partial unions" (<50% of diaphysial circumference) as well as a lower count of necessary pin restabilisations per patient. There was no correlation between time to bone union and the duration of active inflammation prior to the surgical treatment or the presence of an open fistula.
  
  
  CONCLUSIONS
  1. The modernised design allows for dynamic load bearing by the bone tissue between the fragments rather than by the fixator's static beams. 2. The biomechanical principle of the fixator provides for optimal bone healing and shortens the time to bone union.
authors.affiliation: Adult Orthopaedics Ward, Orthopaedic Department of the Center of Postgraduate Medical Education Prof. A. Gruca Independent Public Research Hospital, Otwock, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Białecki
authors.affiliation: Adult Orthopaedics Ward, Orthopaedic Department of the Center of Postgraduate Medical Education Prof. A. Gruca Independent Public Research Hospital, Otwock, Poland.
authors.forename: Adrian
authors.initials: A
authors.lastname: Brychcy
authors.affiliation: ATMED Medical Technology Agency - Zygmunt Rafalski, Poland.
authors.forename: Zygmunt
authors.initials: Z
authors.lastname: Rafalski
authors.affiliation: Adult Orthopaedics Ward, Orthopaedic Department of the Center of Postgraduate Medical Education Prof. A. Gruca Independent Public Research Hospital, Otwock, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Marczyński
authors.affiliation: Adult Orthopaedics Ward, Orthopaedic Department of the Center of Postgraduate Medical Education Prof. A. Gruca Independent Public Research Hospital, Otwock, Poland.
authors.forename: Stanisław
authors.initials: S
authors.lastname: Rak
mesh_terms: D000328:Adult; D001847:Bone Diseases / Q000601:surgery*; D017760:Bone Malalignment / Q000601:surgery*; D016267:External Fixators; D017102:Fracture Healing / Q000502:physiology; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D007867:Leg Bones / Q000293:injuries*; D008875:Middle Aged; D011044:Poland; D012086:Reoperation / Q000295:instrumentation* / Q000379:methods*