External Fixation

What Is External Fixation?

External fixators are devices that can be quickly applied to keep bones stabilized. Surgeons use external fixation for fractures, especially if the broken bone is accompanied with significant swelling, bone loss or soft tissue loss. People with severe open fractures may have an external fixator placed on the injured limb before receiving a permanent implant. Your healthcare provider may suggest external fixation if you have a condition that delays skin healing, including diabetes, rheumatoid disease or peripheral vascular disease.

External fixation is also used during limb-lengthening surgery to correct leg length discrepancies in children or during other procedures for limb deformities, such as bowed legs.

Before External Fixation

Although external fixation is a minimally invasive orthopaedic surgery, there is a period of adjustment to the device. Taking steps to prepare now can help you focus on recovery after surgery. Some steps include:

  • Arranging for time off work while getting accustomed to the device
  • Asking your physician if you would benefit from crutches, a walker or wheelchair during recovery
  • Having clothes ready to go that will fit over the rings of the frame. This includes shorts, loose skirts and dresses, and pants with side zippers or Velcro.
  • Placing extra pillows on your bed to help position your limb
  • Preparing meals that can be easily frozen and reheated

During External Fixation

You will be given anesthesia to be put to sleep throughout the surgery. During the procedure, the surgeon will insert metal pins or wires into the bone above or below the injury site. The pins are attached to a metal bar outside of the body. The external fixator frame will keep the injured bone stable and aligned.

After External Fixation

After your procedure, your provider will give you detailed instructions for recovery. Following these closely will help you avoid infection and heal more quickly. You will likely be instructed to:

  • Adjust struts on the device, if used for limb lengthening. External fixators have adjustable rods to help lengthen the bone. Follow your orthopaedic team’s instructions for turning the struts daily.
  • Attend physical therapy for the injured bone, or follow any at-home rehabilitation instructions you’re provided.
  • Go to follow-up appointments. This helps your healthcare team monitor your progress and watch for possible infections.
  • Keep pins clean. Germs can easily get underneath the skin where the pins are inserted. Clean each pin site daily, unless otherwise instructed by your doctor. You will also need to clean the steel bars with solution.
  • Shower with care. Most patients can begin showering after 10 days. Use gentle, non-perfumed soaps. Don’t submerge your external fixator in water. Make sure to dry the device thoroughly with a towel after showering.
  • Take all prescribed medications. This will help reduce swelling, pain and muscle spasms.


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