External fixation is a process for fracture fixation by which pins or wires are inserted into bone percutaneously and held together via an external scaffold. Initially described by Malgaigne in 1853, external fixation was proposed as an alternative to immobilization in plaster cast, traction, or internal fixation. Circular external fixation with thin wire fixation was popularized by the Ilizarov technique in the 1970s and 1980s, further evolving into hybrid fixation systems using both thin wires and standard half-pins for periarticular fractures.
Unilateral external fixators have a straight rod that is placed on one side of the arm, leg, or foot. It is attached to the bone by a screw, usually coated with hydroxyapatite, to improve the "fixation" of the screw in the bone and prevent loosening. The patient (or family member) may need to adjust the device by turning the knob several times a day.
Typical external fixator patients wear the device from four to twelve months. The severity of the problem you need reconstructed, your health, weight and other factors play a role in the length of time you will need to wear the external fixator.
Wearing an external fixator can limit your mobility, but it's only a matter of time before it's removed. Try to keep as many routines and social activities as possible at home - you'll find that your external fixator doesn't interfere with them too much. At first, you will walk with crutches.
Needle site infection is the most common complication of circular external fixators. It is important to maintain a stable structure throughout the treatment, as loosening of the fixation can lead to inflammation of the surrounding soft tissue. An unstable external fixator may lead to a higher likelihood of needle site infection.
Clean the infected needle site with alcohol or hydrogen peroxide twice a day. Be sure to rinse with salt water after cleaning to remove excess alcohol and peroxides, which can irritate the skin.
After removing the external fixator, the needle site is not sutured until it heals. They usually close and form small scars within four to six days. Sometimes these scars are large and dimpled, while other times they heal with small scars.