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Stability of structures

Stability of structures

In mechanical engineering, the stability of systems under various forces is critical for designing durable and efficient structures. One fundamental way to explore these concepts is by analyzing systems like two rods connected at a pivot point, O, with a torsional spring of spring constant k at the pivot point. This system is similar in appearance to a scissor jack used to change tires on a car. In this case, the arms of the linkage (equivalent to the rods in this system) are entirely vertical,...

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Comparing internal and external stabilization for traumatic elbow instability: a systematic review.

John J Heifner¹, Ty A Davis², Robert J Rowland²

¹Miami Orthopaedic Research Foundation, Miami, FL, USA.

JSES Reviews, Reports, and Techniques

|May 6, 2024

Summary

This summary is machine-generated.

External fixation (ExFix) for traumatic elbow instability showed a higher rate of recurrent instability and pin-related complications compared to the internal joint stabilizer (IJS). The IJS demonstrated a potentially safer complication profile for elbow instability treatment.

Keywords:

Elbow instability External fixation Hinged external fixator Internal joint stabilizer Persistent instability Pin-tract infection

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Area of Science:

Orthopedic Surgery
Trauma Care
Biomedical Engineering

Background:

Traumatic elbow injuries often result in persistent instability despite surgical repair.
Temporary internal joint stabilizers (IJS) or external fixators (ExFix) may be necessary to support repaired structures and maintain joint alignment.
Comparative data on complication risks between ExFix and IJS for elbow instability are limited.

Purpose of the Study:

To systematically review and compare the complication profiles of external fixation (ExFix) and internal joint stabilizers (IJS) in managing traumatic elbow instability.
To synthesize existing literature to inform clinical decision-making regarding the optimal fixation method.

Main Methods:

A systematic literature review was conducted following PRISMA guidelines.
Studies comparing ExFix and IJS for acute or chronic elbow instability in adult patients were included.
Risk of bias and quality assessment were performed using established frameworks.

Main Results:

The rate of recurrent instability was 7.0% with ExFix (N=435) versus 4.1% with IJS (N=171), OR 1.93 (95% CI 0.88-4.23).
Device failure rates were similar: 4.1% for ExFix and 4.4% for IJS.
Pin-related complications were frequent with ExFix (14.6%), while IJS complications included inflammatory reactions and surgical site infections.

Conclusions:

A notable difference exists in the complication profiles of ExFix and IJS for traumatic elbow instability.
External fixation is associated with a higher incidence of pin-related complications and a trend towards increased recurrent instability.
The internal joint stabilizer may offer a favorable alternative with a distinct, potentially lower, complication profile.