Ring Fixator For Tibial & Femur Fracture

The basic goal of fracture fixation is to stabilize the fractured bone, to enable fast healing of the injured bone, and to return early mobility and full function of the injured extremity.

External fixation is a technique used to help heal severely broken bones. This type of orthopedic treatment involves securing the fracture with a specialized device called a fixator, which is external to the body. Using special bone screws (commonly called pins) that pass through the skin and muscle, the fixator is connected to the damaged bone to keep it in proper alignment as it heals.

What is an external fixator used for?

An external fixation device may be used to keep fractured bones stabilized and in alignment. The device can be adjusted externally to ensure the bones remain in an optimal position during the healing process. This device is commonly used in children and when the skin over the fracture has been damaged.

What are the types of external fixator?

There are three basic types of external fixators: standard uniplanar fixator, ring fixator, and hybrid fixator.

The numerous devices used for internal fixation are roughly divided into a few major categories: wires, pins and screws, plates, and intramedullary nails or rods.

Staples and clamps are also used occasionally for osteotomy or fracture fixation. Autogenous bone grafts, allografts, and bone graft substitutes are frequently used for the treatment of bone defects of various causes. For infected fractures as well as for treatment of bone infections, antibiotic beads are frequently used.

Ring Fixator for Tibial & Femur Fracture: An Overview

Fractures of the tibia and femur can be challenging to treat, and the traditional methods of fixation such as plates and screws or intramedullary nails may not always provide satisfactory results. In recent years, the use of ring fixators has become increasingly popular for treating complex tibial and femur fractures. This article aims to provide a comprehensive overview of ring fixators, their indications, surgical technique, and outcomes.

What is a Ring Fixator?

A ring fixator is an external fixation device that comprises of metal rings connected by rods, wires, or screws. The rings are secured to the bone by pins or wires that penetrate the skin and are anchored to the bone. The device creates a stable frame around the limb that allows for precise control of the bone fragments' position and alignment. The stability of the frame allows early mobilization and weight-bearing, leading to faster healing and better outcomes.

Indications for Ring Fixators

Ring fixators are indicated for a wide range of tibial and femur fractures, including open fractures, non-unions, malunions, and fractures with extensive soft tissue injuries. They are also useful in cases where traditional methods of fixation are not possible or have failed. In addition to their use in fractures, ring fixators are also used in limb lengthening procedures and correcting deformities.

Surgical Technique

The placement of a ring fixator is a complex procedure that requires careful planning and meticulous execution. The surgery is performed under general anesthesia or spinal anesthesia, and the patient is placed in a supine or lateral position depending on the fracture location. The pins or wires are inserted percutaneously or through small incisions, and the rings are attached to them. The wires are tensioned to provide stability and compression to the fracture site. After the placement of the frame, the limb's alignment is checked and adjusted as necessary. Postoperatively, the patient is encouraged to start early mobilization and weight-bearing as tolerated.

Complications

Complications associated with ring fixators include pin tract infections, wire or pin breakage, joint stiffness, and neurovascular injuries. The incidence of complications can be reduced by proper pin placement, appropriate tensioning of wires, and regular pin site care. The incidence of major complications is low, and most can be managed conservatively or with simple surgical procedures.

Outcomes

Ring fixators have shown excellent outcomes in the treatment of complex tibial and femur fractures. They allow for early weight-bearing, leading to faster healing and better functional outcomes. Studies have shown that ring fixators have a higher union rate, lower infection rate, and lower reoperation rate compared to traditional methods of fixation.

Conclusion

Ring fixators are a valuable tool in the treatment of complex tibial and femur fractures. They provide stable fixation, precise control of alignment, and allow for early mobilization and weight-bearing. While the placement of a ring fixator is a complex procedure, the outcomes are excellent, with lower complication rates compared to traditional methods of fixation.

FAQs

1. Is a ring fixator painful?

While the placement of a ring fixator can cause discomfort and pain, pain management is an essential part of the postoperative care plan.

1. How long does a ring fixator stay in place?

Ring fixators are typically in place for six to eight weeks, after which they are removed in a simple outpatient procedure.

1. Can I shower with a ring fixator?

Showering with a ring fixator is possible with proper precautions. Cover the frame with a waterproof cast cover or plastic bag to keep it dry.