External Fixation: A Revolutionary Method for Fracture Treatment

 
External Fixators

It is a surgical method to stabilize and immobilize fractures without opening the bone. It is considered one of the most versatile fracture treatments available. They are also known as external skeletal fixators or frames. They are useful for unstable fractures where internal fixation is not possible or is contraindicated.

How It Works?

An External Fixators system uses pins or wires that are placed through the skin and into bones above and below the fracture site. The pins act as anchors to attach the external fixator. It consists of metallic rods or bars that connect to the pins and are secured outside the skin allowing the surgeon to align and hold the broken bone fragments in proper position.

Types of External Fixation Devices

There are different types of external fixators based on their design and application:

Monoaxial Fixators

Monoaxial fixators are one of the most basic types that allow adjustments in one plane only. They provide stability in compression or distraction of fracture fragments. These are commonly used for injuries requiring minimal stabilization like ankle or wrist fractures.

Circular Fixators

Circular fixators offer a 360-degree fixation by placing multiple rings around a limb connected by struts or fixator rods. This allows manipulation of fracture fragments in different vectors enabling multiplanar corrections. Circular frames are ideal for managing complex fractures and limb lengthening procedures.

Hybrid Fixators

Hybrid combine features of circular and linear fixators. They provide a balance between stability and opportunities for corrections. These fixators find application in situations needing sturdier stabilization than a monoaxial frame.

Ilizarov Fixator

Developed by Russian orthopedic surgeon Gavriil Abramovich Ilizarov, this circular frame design allows precise adjustment and application of distraction osteogenesis methods. The technique stimulates new bone growth between fragments for correcting deformities.

Half-Pin Versus Wire Fixation

Half pins are threaded pins that pass entirely through the bone fragment. Wire fixation requires thin wires to be threaded through skin and bone around the fracture site. Half pins offer a more secure grip but wires allow minimal soft tissue stripping and more points of fixation. The choice depends on the fracture morphology and location.

Applications of External Fixation

Some common clinical scenarios necessitating external fixation include:

- Open fractures with severe soft tissue damage where internal fixation poses risk of infection
- Fractures in limbs with poor bone quality
- Limb injury accompanying vascular trauma
- Multiple trauma cases requiring stabilization before internal fixation
- Bone infections where intramedullary nailing is contraindicated
- Limb lengthening and reconstruction surgeries
- Treatment of tibial plateau and patellar fractures
- Spinal injuries with neurological deficits

Advantages of External Fixation

The main advantages of external fixation over internal fixation methods are:
- Minimally invasive with less soft tissue stripping
- Reduced risks of infection from implantation of foreign materials inside bones
- Ability to monitor the fracture site and provide additional stabilization as required
- Allows repeated adjustments for reduction and alignment of fragments
- Facilitates early motion of adjacent joints
- Versatile options for treating complex multi-planar fractures

Disadvantages of External Fixation

 Some drawbacks to consider with external fixation include:

- Pins pose risks of complications like loosening, migration or breakage
- Pinsite injuries, pin-tract infections are relatively common
- Demands patient cooperation to prevent pin contamination during dressing changes
- Fracture stabilization may not be as rigid as plate fixation in some cases
- Fixators require additional surgeries for implant removal once fracture heals

external fixators is a useful technique for temporary or definitive management of fractures not amenable to internal fixation. Its minimally invasive, adjustable and versatile nature offer benefits over traditional plating in select clinical scenarios. With proper surgical skills and postoperative pin care, external fixation provides an effective solution for complex orthopedic injuries.

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About Author:

Ravina Pandya, Content Writer, has a strong foothold in the market research industry. She specializes in writing well-researched articles from different industries, including food and beverages, information and technology, healthcare, chemical and materials, etc. (https://www.linkedin.com/in/ravina-pandya-1a3984191)


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