{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:53:36Z","timestamp":1781589216685,"version":"3.54.5"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100010109","name":"Medical University of Graz","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100010109","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Trauma Emerg Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>External fixators are essential for the surgical management of long-bone fractures, particularly in resource-limited settings where access to commercial systems is often restricted by cost and logistics. This study aimed to develop a low-cost external fixation concept using widely available construction materials and evaluate its biomechanical performance under axial loading.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An external fixator composed of M10 threaded rods, washers, and nuts was developed. Five configurations were tested: SP (Steinmann pins), KT (threaded K-wires), KS (smooth K-wires), and BKS (bilaterally applied, smooth K-wires). A commercial external fixator served as control (CG). Juvenile bovine ulnae with a standardized fracture gap were subjected to cyclic axial loading. Construct stiffness, elastic deformation, and plastic deformation were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CG showed the highest stiffness (107.80\u2009\u00b1\u200914.12\u00a0N\/mm), followed by SP (87.73\u2009\u00b1\u200917.92\u00a0N\/mm), BKS (83.81\u2009\u00b1\u200910.01\u00a0N\/mm), KS (49.84\u2009\u00b1\u20093.80\u00a0N\/mm), and KT (46.66\u2009\u00b1\u20092.39\u00a0N\/mm). Post-hoc analyses showed no significant differences between CG vs. SP and CG vs. BKS, whereas KT and KS were significantly less stiff. Elastic deformation followed a similar pattern. Plastic deformation was greatest in CG, while SP and BKS showed significantly lower values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The threaded-rod fixator provides relevant mechanical stability at extremely low material cost. As a first biomechanical proof-of-concept, this approach may offer a practical and immediately deployable stabilization method for resource-limited settings when standard external fixators are unavailable. It could serve either as a definitive treatment or as part of a damage control strategy prior to transfer. Further biomechanical, cadaveric, and clinical studies are required before clinical application can be considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00068-026-03246-w","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:23:52Z","timestamp":1781587432000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development of a low-cost external fixation system: an off-label solution for resource-limited settings"],"prefix":"10.1007","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3250-8514","authenticated-orcid":false,"given":"Martin","family":"Seiser","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3235-0964","authenticated-orcid":false,"given":"Christian","family":"Deininger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2706-3285","authenticated-orcid":false,"given":"Johann","family":"Fierlbeck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9537-9070","authenticated-orcid":false,"given":"Marianne","family":"Hollensteiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Coles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caspar","family":"Reuter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herbert","family":"Tempfer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Traweger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Wichlas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"issue":"1","key":"3246_CR1","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/s00264-021-05213-z","volume":"46","author":"ND Rossiter","year":"2022","unstructured":"Rossiter ND. 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