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pubmed-article:9379268pubmed:abstractTextFlexible fixation of fractures with minimally invasive surgical techniques has become increasingly popular. Such techniques can lead to relatively large fracture gaps (larger than 5 mm) and considerable interfragmentary movements (0.2-5 mm). We investigated the influence of the size of the fracture gap, interfragmentary movement, and interfragmentary strain on the quality of fracture healing. A simple diaphyseal long-bone fracture was modeled by means of a transverse osteotomy of the right metatarsus in sheep. In 42 sheep, the metatarsus was stabilized with a custom-made external ring fixator that was adjustable for gap size and axial interfragmentary movement. The sheep were randomly divided into six groups with three different gap sizes (1, 2, or 6 mm) and small or large interfragmentary strain (approximately 7 or 31%). The movement of the fracture gap was monitored telemetrically by a displacement transducer attached to the fixator. After 9 weeks of healing, the explanted metatarsus was evaluated mechanically in a three-point bending test to determine bending stiffness and was radiographed to measure the amount of periosteal callus formation. Increased size of the gap (from 1 to 6 mm) resulted in a significant reduction in the bending stiffness of the healed bones. Larger interfragmentary movements and strains (31 compared with 7%) stimulated larger callus formation for small gaps (1-2 mm) but not for larger gaps (approximately 6 mm). The treatment of simple diaphyseal fractures with flexible fixation can be improved by careful reduction of the fracture; this prevents large interfragmentary gaps. The experimental fracture model for the metatarsus showed that the healing process was inferior when the gap was larger than 2 mm.lld:pubmed
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pubmed-article:9379268pubmed:authorpubmed-author:ClaesLLlld:pubmed
pubmed-article:9379268pubmed:authorpubmed-author:WilkeH JHJlld:pubmed
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pubmed-article:9379268pubmed:volume15lld:pubmed
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pubmed-article:9379268pubmed:pagination577-84lld:pubmed
pubmed-article:9379268pubmed:dateRevised2006-11-15lld:pubmed
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pubmed-article:9379268pubmed:year1997lld:pubmed
pubmed-article:9379268pubmed:articleTitleInfluence of size and stability of the osteotomy gap on the success of fracture healing.lld:pubmed
pubmed-article:9379268pubmed:affiliationAbteilung Unfallchirurgische Forschung und Biomechanik, Universität Ulm, Germany. claes@sirius.medizin.uni-ulm.delld:pubmed
pubmed-article:9379268pubmed:publicationTypeJournal Articlelld:pubmed
pubmed-article:9379268pubmed:publicationTypeResearch Support, Non-U.S. Gov'tlld:pubmed
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