An external skeletal fixator is an orthopedic method for treating open or closed fractures of long tubular bones, joint stiffness, bone lengthening, and congenital malformations. An external skeletal fixator is a device that is installed outside the organ and inserts pins into the fracture to fix it and adjust the position of the pin. They are connected to the frame and secured with bolts and nuts. Fixtures have changed significantly in appearance and biomechanics over time, but the principle and function remain the same. These fixtures consist of pins or thin stainless steel wires that penetrate the skin and reach the bone. This way the broken part is fixed in the right direction. Depending on the body geometry and shape, these external skeletal fixators are available in different types such as linear, circular, and hybrid fixators. The simplest and most common type of external skeletal fixator is the linear fixator. The use of an external fixator has several advantages over other fixation methods such as stabilization of the fracture at some distance from the injury site, no need for a cast, ease of patient movement, and minimal involvement of the joint. Premature loosening of the pin is the most common complication causing pain, inflammation, and discharge from the pin tract. Although these fixators are versatile and effective treatment models, they require careful maintenance during treatment. Before deciding to use an external fixator, the patient's and pet's owner's ability to comply with postoperative care instructions should be considered. This article reviews the types of external fixators, postoperative care, and their complications.

Periprosthetic fractures about the humerus are a rare but difficult complication of shoulder arthroplasty, occurring in up to 3% of cases. Depending on the fracture pattern, open reduction and internal fixation (ORIF) may be used to definitively treat these injuries. This article demonstrates a new technique that uses a distal femoral locking plate to maximize bony fixation of such periprosthetic humeral fractures. Between November 2008 and July 2016, three patients with periprosthetic humerus fractures were treated with open reduction internal fixation using a distal femoral locking plate. All patients were followed until radiographic: union: . Fractures occurred at a mean of 5. 2 years after arthroplasty (range, 1 to 7. 5 years). Two of the fractures were classified as Wright-Cofield Type C and one fracture was Wright-Cofield Type B. Surgical fixation was performed at a mean of 6 days after fracture. All were treated with a fixed angle distal femoral locking plate. Healing was confirmed radiographically for all three patients at a mean of 11. 8 months (range 3 to 28. 5 months). No patient required reoperation. Obtaining adequate bony fixation around periprosthetic humerus fractures remains challenging. The use of a distal femoral locking plate may be helpful in patients with long stem prostheses which require increased distal fixation.

Background: Distal radius fractures (DRFs) are much more prone to malunion than unstable extra-articular fractures. There is no clear consensus concerning what the proper treatment should be, and the best approach to use for displaced DRFs remains challenging.Objective: To compare the effect of two different therapeutic surgical methods, i.e., volar plate fixators and external fixators, on outcomes of patients with intra-articular distal radius fractures.Methods: From May 2010 to November 2014, 76 subjects who had experienced intra-articular fractures of the distal radius were enrolled in this double-blind, randomized, controlled trial in Imam Ali Hospital in Bojnourd, Iran. The patients were divided into two groups, i.e., 1) patients who were treated with internal fixation using the volar plate (group A) and 2) patients who were treated with external fixators (group B). The primary outcome was a composite measure of the patient’s quality of life using three different scores, i.e., 1) the MAYO score, 2) Disabilities of the Arm, Shoulder, and Hand (DASH (score,  and 3) the Short Form (36) (SF-36) Health Survey score.Results: A total of 76 patients were allocated randomly to groups A and B. The mean ages for external fixator cases and volar plate cases were 51.7 and 46.3, respectively. No significant age distribution was seen between the two groups (p=0.348). Gender distribution between the two groups was not significantly different (p=0.022). Grip power was significantly different between the two groups, but no significant differences were detected in range of motion (p=0.008, p=0.367, respectively). The MAYO score was significantly higher in the open reduction and internal fixation (ORIF) group, and, according to the SF-36 test, the ORIF group also a higher level of general mental and physical health, social functioning, and personal physical functioning than the other group. However, postoperatively, the mental discomfort and physical discomfort were more prevalent in the external fixator group. The DASH score was not significantly different between the two groups (p=0.124).Conclusions: ORIF and its subtitle, volar plate fixation, is a more preferred surgical procedure than the external fixator for the treatment of intra-articular distal radius fractures. This conclusion is important when one considers cost-effectiveness and an earlier return to work.Trial registration: The trial is registered at the Thai Clinical Trial Registry (clinicaltrials.in.th) with the TCR identification number TCTR20150609002Funding: The authors received no financial support for the research, authorship, and/or publication of this article.

Background and Objective: Various surgical techniques, including Open Reduction and Internal Fixation (ORIF), Minimally Invasive Plate Osteosynthesis (MIPO), and External Fixation (EF), have been proposed for the tibial pilon fractures treatment. However, limited comparative data exist regarding the outcomes of these three methods. Despite advancements in surgical procedures, the outcomes have not consistently been excellent, and patients often experience numerous complications. This study aimed to evaluate the outcomes and complications of the tibial pilon fractures treatment in a six-month follow-up. Methods: This descriptive-analytical prospective cohort study was conducted on 22 patients (18 men and 4 women; mean age=39.4±10.8 years) who presented with tibial pilon fractures at the Fifth Azar Educational-Therapeutic Center in Gorgan, Iran, from April 2020 to March 2022. All 22 eligible patients agreed to participate. Following the necessary treatment determined by the attending physician, patients were examined after six months, and their outcomes were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) ankle score. Results: The majority of fractures (54.5%) were of closed type. The surgical procedures performed included two-stage EF (40.9%), ORIF (31.8%), expert nailing (13.6%), and MIPO (13.6%), respectively. A total of 72.7% of patients experienced early or late postoperative complications. The most common postoperative complications were osteoarthritis and wound dehiscence, occurring at a rate of 18.2% each. The mean AOFAS score for patients was 82.3±11.2. AOFAS scores were classified as excellent in 4 patients (18.18%), good in 12 patients (54.55%), moderate in 4 patients (18.18%), and poor in 2 patients (9.09%). A statistically significant inverse correlation was observed between the mean surgical time and the AOFAS score (r=−0.661, P=0.001). Furthermore, a statistically significant direct correlation was found between the mean surgical time and the mean length of hospital stay (r=0.571, P=0.006). Surgical time for patients undergoing MIPO (68.3±7.6 minutes) was significantly shorter than that of the other three methods (P<0.05). For open fractures, the frequency of ORIF was significantly higher than that of other procedures (P<0.05). Osteoarthritis was observed as a treatment complication in both expert nailing and two-stage EF interventions. In contrast, non-union and wound dehiscence complications were exclusively observed following ORIF. Superficial infection and mal-union were only observed after two-stage EF, and all instances of deep infection occurred with MIPO. Conclusion: Two-stage EF and ORIF were the most common surgical techniques employed for patients with tibial pilon fractures. Worse postoperative complications, including non-union and wound dehiscence, commonly occurred in ORIF procedures. However, there was no statistically significant difference in patient-reported outcomes based on the AOFAS self-report questionnaire among the various surgical techniques.

Background: Femoral neck fracture is considered to be one of the most devastating and common injuries encountered by orthopedic surgeons. Over 150000 femoral neck fractures occur every year in the United States (US), and in accordance with aging of the population, this number will be doubled by the year 2050. This condition can be considered as a healthcare burden with notable socioeconomic impact worldwide (1-3). Regarding the Garden classification, type 1 and 2 are considered impacted or undisplaced femoral neck fracture (UFNF) (4). Although the treatment of displaced femoral neck fracture in the elderly is commonly defined as hip arthroplasty, the treatment for UFNF is still controversial (5, 6). . .

Sound is one of the forms of mechanical energy and the two main characteristics of sound are intensity or power and frequency or wavelength of sound.their performance against the incoming sound wave, industrial silencers can be divided into two general groups of resonating and absorption silencers, the main difference between these silencers is the release of sound energy from the channeling system, which is one of the common examples of the use of resonating type silencers, their use in It is the internal combustion engines that distinguish absorption silencers from the resonator type based on the fact that the main and visible part of the act of muting the sound is achieved by changing sound energy to heat energy.The goal of this article is to design a muffler based on the breaking of sound frequencies resulting from the movement of fluid in the exhaust output of vehicles, which leads to a reduction of at least 50 db of sound and gives the operator enough peace and concentration. In this article, after examining three types of mufflers, absorbent mufflers that use the properties of porous absorbent material to absorb passing sound and are the simplest form of mufflers, have been selected, analyzed and reviewed and are suitable for the OM457 engine of Idem Industrial Company. It designed for maximum inlet exhaust temperature is 520 and for the maximum kW power is 315 with the maximum discharge relative pressure of 185 mbar for homogenization with the standard atmosphere.

Background and Aim: Cranfixer was approved in 2017 by the Food and Drug Administration of Iran as a skull flap fixation and also a burr hole cover. The effectiveness and safety of this commercial medical device were investigated in detail by the regulatory auditors. Methods and Materials/Patients: Cranfixer was used for ninety-five patients. Sixty patients were selected from a list if they had at least two follow-ups after surgery. The following variables were investigated: age, gender, number of Cranfixers, device loosening, infection, and prominence. In addition, a retrospective review was performed about the reason of surgery. Results: Flap loosening and infection were the major variables surveyed. On average, two Cranfixers were used for each patient. Patients’ median age was 44 years. There was no sex preference (50% male). The craniotomy occurred in frontal (50%), occipital (3%), parietal (20%), and temporal (27%) lobes. Based on examination and CT imaging, no cases of loosening were observed. Just in one patient, one of two Cranfixers was infected (P<0. 001). Conclusion: The reliability and functionality of Cranfixer were proved in pre-market test and the results of this study confirm them. Cranfixer provides safe, reliable and long-term functionality.

Objective: The goal of this study was to design and manufacture a new type of foot orthosis that is used for preventing of equinus deformity of ankle complex in patient with ankle fracture or tibial lengthening by U shape Elizarov external fixator. Material & Methods: In present discovery study; after casting the patient’s foot in neutral position, during afew steps orthosis that can joined to the U shape Elizarov external fixator, has been designed and manufactured. Results: According to the results of this study, in new orthosis, the ankle complex will be in neutral position by joining the U shape Elizarov external fixator to it. The patient with orthosis can walk and his or her Activity daily living improve. Conclusion: For the first time a new type of foot orthosis, for preventing of equinus deformity of ankle complex in patient that have to used U shape Elizarov, has been designed and manufactured.

The role of external fixators in hand injuries is well entrenched, especially in complex, comminuted phalangeal, and metacarpal fractures where internal fixation is not always possible. We describe a simple, low cost, lightweight, and “, easy to construct and easy to use”,mini-fixator which can be used for complex, comminuted, open, or closed thumb fractures for definitive fixation with consistent and predictable outcomes. These self-made mini-fixators can also be used for other phalangeal and metacarpal fractures. This represents a viable, alternative option to commercially available mini-fixators which are costly, not readily available, and complicated to use.