explaining the principles and techniques of external fixation - done during basic ortho skills course

1. PRINCIPLES OF EXTERNAL
FIXATOR

2. INDICATIONS
 Systemic damage control

3.  Local damage control
Open fractures Closed fractures with severe
soft tissue damage

4.  Reduction through capsuloligamentotaxis

5. STABILITY
 Diameter of pin and bar
 most important contributor – rigidity α r4
 Sizes – 8mm, 11mm
 Pin size ≤ 1/3rd diameter of bone – risk of breaking
it

6.  Near – far concept

7.  Other factors

8.  which construct better?

9.  which construct better?

10.  Most common reason of construct failing?

11. What does this stability
confer?
 Load sharing
with good
reduction

12. What does this stability
confer?
 Wound management

13. What does this stability
confer?
 Improves soft
tissue tension

14. What does this stability
confer?
 capsuloligamentotaxis

15. SAFE CORRIDORS

16. SAFE CORRIDORS

17. PIN PLACEMENT
 Avoid critical
soft tissue –
NV, joints,
tendons and
damaged soft
tissue

18. PIN PLACEMENT
 Stable frame construct

19. PIN PLACEMENT
 Avoid zone of
injury

20. PIN PLACEMENT
 Avoid zone of
definitive
surgery

21. PIN PLACEMENT
 Allow
access to
soft tissue
for
coverage
plans
later

22. PIN PLACEMENT
 Allow access to soft tissue for coverage
plans later

23. TECHNIQUE
 Pin insertion
 Frame construct