Source of the slippage in the universal joints of the Hoffmann external fixator

An investigation was conducted to determine what improvements in the resistance to slippage could be obtained in selected interfaces (rod/clip torsional, cheek/bowl and cheek/clip) of the Hoffmann external fixator. The modification involved changing the standard wing-nut clamp for a bolt with a thread of 7 mm and a 1 mm pitch and placing an FAG 28–303 thrust-bearing (needle roller and cage assembly) between the bolt and the cheek. The results showed a significant improvement in the slippage values of all interfaces; increases of approximately six times were obtained at all torque values of the wing-nut clamp or fastener tested. Such improvements would markedly increase the reliability of external fixation systems and thus reduce the incidence of loss-of-reduction of fracture due to slippage of the universal joint.