Mechanical comparison of two external fixator clamp designs

To compare two external fixation clamp designs for their ability to resist movement of a fixation pin in relation to the connecting rod.

Two designs of external fixator clamps were attached to connecting rods mounted on a jig for mechanical testing. Fixator pins were placed perpendicular to the connecting rod. A mechanical testing machine was used to deflect each 3.2-mm pin at a distance that was 25 mm from the center of the clamp bolt. Both clamp designs were tightened to 4.4, 6.1, and 7.8 newton-meters (N x m) torque, and loads were applied in a position ramp through 4 mm and resisting loads were measured. Two clamp orientations were used during load application, such that the deflection of the pin tended to tighten the clamp bolt or tended to loosen the clamp bolt. The tests were videotaped to determine mode of failure. Comparisons of the load/displacement curves for the two external fixator clamp designs were made using nonlinear equational curve fitting methods. The resultant plateau and rise coefficients were compared using analysis of variance.

Slippage of the pin in relation to the clamp occurred with the Kirschner-Ehmer clamp tightened to 4.4, 6.1, and 7.8 N x m, and slipping of the pin in relation to the clamp occurred with the experimental clamp design tightened to 4.4 and 6.1 N x m but not to 7.8 N m. At 7.8 N x m, the 3.2-mm pin deformed plastically with the experimental clamp design. Increasing the torque of the clamp bolt resulted in superior plateau coefficients for both clamp designs. At each level of tightness and in each clamp orientation to applied pin load, the experimental clamp design provided greater plateau coefficients than did the Kirschner-Ehmer clamp design. At 7.8 N x m of tightness, the Kirschner-Ehmer clamp and bolt bent, whereas only slight plastic deformation of the experimental clamp design occurred.

The experimental external fixator clamp was more secure in resisting fixator pin movement at all levels of tightening compared with the Kirschner-Ehmer-type external fixator clamp. At 7.8 N x m of tightening, the new clamp design did not allow slippage of the pin within the clamp.

The experimental external fixator clamp should result in greater rigidity of fixator configurations, in addition to providing design features that allow addition of a clamp between two installed clamps, sleeved predrilling of pilot holes for all pins, measurement of pin depth, and placement of positive profile pins at all sites.