OrthopaedicPrinciples.com

Integrating Principles and Evidence

Integrating Principles and Evidence

  • Home
  • Editorial Board
  • Our Books
    • Evidence Based Orthopaedic Principles
  • Courses
  • Exams
  • Reviews
  • Live Program
  • Contact

Biomechanics of External Fixation

EXTERNAL FIXATION
The traditional modern conception of external fixation started with JeanFrancois Malgaigne. The first use of “pins” is credited to Malgaigne who, in 1840, created a simple metal pin in a leather strap for the percutaneous pin treatment of tibial fractures

Advantages

  • Less damage to the blood supply of the bone
  • Minimal interference with soft-tissue cover
  • Rapid application in an emergency situation
  • Stabilization of open and contaminated fractures
  • Adjustment of fracture reduction and stability without surgery
  • Minimal foreign body in the presence of infection
  • Bone transport and deformity correction possible

*Broadly classified into, pin fixators and ring fixators.
Pin fixators can be used in four basic configurations
1. Unilateral one-plane configuration.
2. Unilateral two-plane configuration.
3. Bilateral one-plane configuration.
4. Bilateral two plane configuration

Spanning external fixation frame (joint bridging):

  • It is indicated for damage-control surgery when the patient (polytrauma), or the limb, or the fracture cannot be definitively managed immediately
  • It is used to span areas of severe soft-tissue injury or complex articular fractures and fracture dislocations
  • The stability allows time for soft tissues to settle, while CT scans and preoperative planning are performed.
  • Unilateral frames are mostly used and the pins should be placed where possible outside the zone of injury and outside the zone of (future) definitive surgery

An external fixator can be made more stable by
1. Increasing the pin diameter
2. Increasing the number of pins
3. Increasing the spread of pins
4. Multiplanar fixation
5. Reducing the bone frame diameter
6. Predrilling and cooling during insertion
7. Radially preload the pins
8. Tensioned wires at 900
9. Stacked frame

Note: a very rigid frame is NOT always good

Complications

  • Pin tract infections
  • Neurovascular impalement
  • Muscle or tendon impalement
  • Delayed union
  • Compartment syndrome
  • Refracture

Courtesy: Saqib Rehman MD
Associate Professor
Director of Orthopaedic Trauma
Temple University
Philadelphia, Pennsylvania, USA
www.orthoclips.com

External fixation bio

Post Views: 11,331

Related Posts

  • Biomechanics of Internal Fixation

    Courtesy: Saqib Rehman MD Associate Professor Director of Orthopaedic Trauma Temple University Philadelphia, Pennyslyvania, USA

  • Biomechanics of Internal Fixation

    Courtesy: Saqib Rehman MD Associate Professor Director of Orthopaedic Trauma Temple University Philadelphia, Pennyslyvania, USA

  • Basic Principles and Biomechanics of Fracture Fixation

    Courtesy: White Coat Coaches

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Follow Us

instagram slideshare

Categories

  • -Applied Anatomy
  • -Approaches
  • -Basic Sciences
  • -Cartilage & Meniscus
  • -Classifications
  • -Examination
  • -Foot and Ankle
  • -Foot and Ankle Trauma
  • -FRCS(Tr and Orth) tutorials
  • -Gait
  • -Hand and Wrist
  • -Hand and Wrist Trauma
  • -Hand Infections
  • -Hip and Knee
  • -Hip Preservation
  • -Infections
  • -Joint Reconstruction
  • -Knee Arthroplasty
  • -Knee Preservation
  • -Metabolic Disorders
  • -Oncology
  • -OrthoBiologics
  • -OrthoPlastic
  • -Paediatric Orthopaedics
  • -Paediatric Trauma
  • -Patellofemoral Joint
  • -Pelvis
  • -Peripheral Nerves
  • -Principles
  • -Principles of Surgery
  • -Radiology
  • -Rheumatology
  • -Shoulder and Elbow
  • -Shoulder and Elbow Arthroplasty
  • -Spine Deformity
  • -Spine Oncology
  • -Spine Trauma
  • -Spine, Pelvis & Neurology
  • -Sports Ankle and Foot
  • -Sports Elbow
  • -Sports Knee
  • -Sports Medicine
  • -Sports Medicine Hip
  • -Sports Shoulder
  • -Sports Wrist
  • -Statistics
  • -Technical Tip
  • -Technology in Orth
  • -Trauma
  • -Trauma (Upper Limb)
  • -Trauma Life Support
  • -Trauma Reconstruction
  • Book Shelf
  • Book Shelf Medical
  • Careers
  • Case Studies and Free Papers
  • DNB Ortho
  • Evidence Based Orthopaedic Principles
  • Evidence Based Orthopaedics
  • Exam Corner
  • Fellowships
  • Guest Editor
  • Guest Reviews
  • Image Quiz
  • Instructional Course Lectures
  • Journal Club
  • MCQs
  • Meetings and Courses
  • Multimedia
  • News and Blog
  • Plaster Techniques
  • Podcasts
  • Public Health
  • Rehabilitation
  • Research
  • Shorts and Reels

Book Shelf

Kendall’s Muscle Testing and Function 6th Edition

Kendall’s Muscle Testing and Function 6th Edition

By admin Leave a Comment

Get Book Kendall’s Muscles: Testing and Function, with Posture and Pain, 6th Edition, transforms this landmark Physical Therapy classic to prepare you for unparalleled clinical success in today’s practice. Timeless coverage of manual muscle testing, evaluation, and treatment meets the latest evidence-based practices, engaging imagery, and dynamic digital resources to create a powerful resource you […]

Popular Posts

  • Bone Screws in Orthopaedic Surgery
  • Silverskold Test
  • Piriformis Syndrome
  • Blood Supply of Long Bone
  • Movements of the Thumb

Recent Comments

  • RAJATABHA BISWAS on NUH Fellowship in Singapore
  • Runj on ESSKA Congress 2026
  • OT Hand Therapist on Interosseous Muscles Of The Hand
  • Badreddine on Rockwood and Green Fractures in Adults and Children- 10th Edition
  • Prof Dr P.sridhar MS Ortho,D Ortho on Rockwood and Green Fractures in Adults and Children- 10th Edition

Exam Corner

FRCS Orth Exam- Knee Arthroplasty

Courtesy: Zaid al Rab, FOunder, OrthoPass

MCQ Exam for the FRCS Orth 1

Courtesy: Zaid al Rub, Founder, OrthoPass

Postgraduate Entrance Exam Set 3

Get explanatory answers from our book

Postgraduate Entrance Exam Set 2

Get explanatory answers from our book

Main Menu

  • Orthopaedic Principles
  • Editorial Board
  • Orthopaedic Principles-A Review

Recent Posts

  • Anterior Tibial Tendon Tears
  • Endoscopic Lumbar Microdiscectomy
  • RAMP Lesion of the Knee
  • Osteochondritis Dissecans of the Knee
  • Dual Mobility Cups in Total Hip Replacement

Links

  • Join Our Editorial Board
  • Journals
  • Weblinks
  • Submit Your Conference
  • Disclaimer
Copyright@orthopaedicprinciples.com. All right rerserved.