Dissipation of Heat During Polymerization of Acrylics Used for External Skeletal Fixator Connecting Bars

Objective — To determine the amount of heat conducted by transfixation intramedullary pins (IP) and Kirschner wires (KW) during polymerization of acrylics used for external skeletal fixator (ESF) connecting bars.
Study Design — Thermal conduction was measured using thermistors applied to IP and KW surfaces during the polymerization phase of acrylics.
Methods — Type II ESF were created from IP or KW placed into wooden dowels and plastic tubing used to create connecting bars filled with one of two types of acrylic (Acrylic Pin External Fixation System or Technovit, Jorgensen Laboratories, Loveland, CO). Thermistors were positioned on the acrylic column surface and on IP or KW surfaces 5 or 10 mm from the acrylic column. Five ESF test groups were created. The maximum temperature (Tmax) of the acrylic column (Tmax-A), IP (Tmax-IP), KW (Tmax-KW), and duration that Tmax-IP or Tmax-KW remained greater than or equal to 55°C were calculated.
Results — All IP and KW thermistors placed 5 mm from acrylic columns reached mean temperatures greater than 50°C and had peak temperature ranges greater than 55°C compared with all IP and KW thermistors placed 10 mm from the acrylic columns in all groups. Thermistors placed 5 mm from the acrylic column in two groups maintained temperatures greater than 55°C for greater than or equal to 0.5 minutes.
Conclusions — Acrylic columns positioned 5 mm from a thermistor on a IP or KW had the potential to reach or exceed temperatures that have been reported to cause thermal necrosis of tissues.
Clinical Relevance — Acrylic Pin External Fixation System or Technovit acrylic connecting bars used in ESF designs have the potential to cause thermal injury to soft and bony tissue by thermal conduction along transfixation pins or wires.