The external fixator was first designed by Russian surgeon, Gavriel Ilizarov in Kurgan, Russia when he was treating soldiers with open fracture injuries.
External fixation is an instrument used for complex reconstructive cases that allows the surgeon to correct issues that are more challenging to correct with internal fixation (screws and plates).
An external fixator is a minimally invasive device that allows the surgeon to protect soft-tissues, span deficits, distract, compress, work around infectious processes, gradually lengthen bones, soft tissues, and neurovascular structures (arteries, veins, nerves). External fixation is commonly used in pediatric deformity correction, Charcot foot and ankle reconstructive surgery, diabetic deformity correction, trauma cases, as well as other type of surgery.
An external fixator is commonly referred to as a “frame” or “ring” and the pins are inserted through the skin and bone and attached to the frame. Depending upon the patient’s orthopedic issues, the frame is adjusted to correct the deformity.
The external fixator is worn by the patient anywhere from 3 weeks to 4 months depending upon the surgery and patient’s issues.
Dr. McLeod has the patient come into her office weekly for frame cleaning, adjustments, pin site checks, x-ray evaluation, and counseling.
The patient also will receive home health care services where a nurse will come to the patient’s home and clean and dress the frame daily. The nurse will also perform medication checks, basic nursing care, and ensure safety. Furthermore, a physical therapist will also come to the house to perform exercises to keep the patient physically conditioned, ensure home safety, reduce fall risk, and ensure activities of daily living can be performed easily.
After the frame is removed, the patient will be placed into a soft splint and followed by a hard cast. Some patient may start protected weight bearing in a boot, whereas, Charcot deformity correction and limb preservation cases may require a CROW boot before weight bearing.
Many patient are initially intimidated by the frame; however, surgical technique has significant effects that could not be achieved by standard internal fixation techniques.