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Biomechanical features of six design of the delta external fixator for treating Pilon fracture: a finite element study

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Abstract

Pilon fractures can be caused by high-energy vertical forces which may result in long-term patient immobilization. Many experts in orthopedic surgery recommend the use of a Delta external fixator for type III Pilon fracture treatment. This device can promote immediate healing of fractured bone, minimizing the rate of complications as well as allowing early mobilization. The characteristics of different types of the Delta frame have not been demonstrated yet. By using the finite element method, this study was conducted to determine the biomechanical characteristics of six different configurations (Model 1 until Model 6). CT images from the lower limb of a healthy human were used to reconstruct three-dimensional models of foot and ankle bones. All bones were assigned with isotropic material properties and the cartilages were assigned to exhibit hyperelasticity. A linear link was used to simulate 37 ligaments at the ankle joint. Axial loads of 70 and 350 N were applied at the proximal tibia to simulate the stance and swing phase. The metatarsals and calcaneus were fixed distally in order to prevent rigid body motion. A synthetic ankle bone was used to validate the finite element model. The simulated results showed that Delta3 produced the highest relative micromovement (0.09 mm, 7 μm) during the stance and swing phase, respectively. The highest equivalent von Mises stress was found at the calcaneus pin of the Delta4 (423.2 MPa) as compared to others. In conclusion, Delta1 external fixator was the most favorable option for type III Pilon fracture treatment.

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Acknowledgements

The work was supported by research funding from Universiti Teknologi Malaysia (UTM) under grant of Potential Academic Staff (PAS) (Q.J130000.2745.02K78), Tier 1 (Q.J130000.2545.20H20), and (Q.J130000.2545.20H26) funding from the Ministry of Higher Education Malaysia under the Fundamental Research Grant Scheme (FRGS) grant.

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  1. Medical Devices and Technology Group (MEDITEG), Faculty of Biosciences and Medical Engineering, Universiti Teknologi Malaysia (UTM), 81310, Johor Bahru, Johor, Malaysia

    Muhammad Hanif Ramlee & Mohammed Rafiq Abdul Kadir

  2. Sport Innovation and Technology Centre (SITC), Institute of Human Centered Engineering (IHCE), Universiti Teknologi Malaysia, 81310, Johor Bahru, Johor, Malaysia

    Muhammad Hanif Ramlee, Mohd Ayub Sulong & Mohammed Rafiq Abdul Kadir

  3. Department of Applied Mechanics and Design, Faculty of Mechanical Engineering, Universiti Teknologi Malaysia, 81310, Johor Bahru, Johor, Malaysia

    Mohd Ayub Sulong

  4. Department of Mechanical Engineering, ETSII, Technical University of Madrid, 28006, Madrid, Spain

    Evelyn Garcia-Nieto, Daniel Angure Penaranda & Antonio Ros Felip

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Ramlee, M.H., Sulong, M.A., Garcia-Nieto, E. et al. Biomechanical features of six design of the delta external fixator for treating Pilon fracture: a finite element study. Med Biol Eng Comput 56, 1925–1938 (2018). https://doi.org/10.1007/s11517-018-1830-3

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  • DOI: https://doi.org/10.1007/s11517-018-1830-3

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