External fixation is a method to provide stability to bone and soft tissue after a bone injury but can also be applied as a procedure to correct misalignment of bone, lengthen a limb, or protect soft tissue after a serious burn or injury.
External fixation is carried out by fixing pins or screws into the bone on both sides of the fracture. The pins are clamped together outside of the skin and a series of clamps and rods form the external frame.
It is generally done by an orthopedic surgeon under general anesthesia. Different steps of the procedure are:
The bones around the fracture which are not damaged are drilled for fixing Pins/ Screws. Special threaded Pins are screwed into the holes. Outside of the body, rods with ball-and-socket joints are fixed with the bolts. The ball-and-socket joint can be adjusted to ensure the bone is aligned properly with as little, if any, shortening of a bone. The areas of skin pierced by the procedure must be cleaned regularly to prevent infection. In some cases, a cast may be applied.
The Pins and external frame can be removed in a doctor’s office without anesthesia. Extended protection is required after removal of the device, as there is likelihood of fractures at the drill sites.
The external fixation option has the main advantage of quick and easy application. The risk of infection at the site of the fracture and where the Pins have been inserted through the skin is a possibility, though minimal.
External fixators are often used in severe traumatic injuries as they allow for rapid stabilization while allowing access to soft tissues that may also need treating. This is particularly important when there is significant damage to skin, muscle, nerves, or blood vessels.
The external fixation also ensures the ideal compression, extension, or neutralization of bone placement while allowing for movement of the nearby joints. This not only aids in setting the bones correctly, it can help minimize muscle atrophy and edema (the buildup of excess fluid) caused the total immobilization of a limb.
External fixation is contraindicated under the following circumstances: Bone-related disorders or deterioration that make stabilization less assured Persons who are not able or willing to properly care for the pins and wires A person with severely compromised immune systems who are at higher risk of infection
Other Uses of External Fixation
Beyond the immediate repair of severe or compound fractures, external fixation can be used to treat or repair other conditions. These include surgeries to correct bone malformations that result in the shortening of a limb.
External fixation can also be used to retain the integrity of bone structures (such as the hand) after a serious burn or injury. Without fixation, the exposed or damaged tissue can contract from the accumulation of scar, causing long-term or even permanent restriction of movement.