Development of a low-cost external fixation system: an off-label solution for resource-limited settings

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Materials science

Background:

• External fixators are crucial for treating long-bone fractures, especially in resource-limited areas.
• High costs and logistical challenges of commercial systems hinder access in these settings.

Purpose of the Study:

• To develop a low-cost external fixation concept using readily available construction materials.
• To evaluate the biomechanical performance of this novel fixator under axial loading.

Main Methods:

• An external fixator was constructed using M10 threaded rods, washers, and nuts.
• Five configurations (SP, KT, KS, BKS) and a commercial control (CG) were tested.
• Juvenile bovine ulnae with fractures underwent cyclic axial loading to assess construct stiffness and deformation.

Main Results:

• The commercial control (CG) exhibited the highest stiffness, but the SP and BKS configurations showed no significant difference.
• The novel threaded-rod fixator (SP and BKS) demonstrated relevant mechanical stability.
• Elastic deformation mirrored stiffness, while plastic deformation was lowest in the SP and BKS groups.

Conclusions:

• The developed threaded-rod external fixator offers significant mechanical stability at a very low material cost.
• This proof-of-concept presents a practical, deployable stabilization method for resource-limited settings.
• Further studies are necessary to validate its clinical applicability for definitive treatment or damage control.