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External Skeletal Fixator (ESF) can be used to repair almost any fracture.

External Skeletal Fixator

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Principals

– Aseptic Technique

– Targetting proper location- tension side, minimize soft tissue injury

– Selection of appropriate frame type based on fracture assessment

– Auxillary fixation if indicated- IM pin +/- tie in, lag screw, ciclage wire

– Maintain reduction and stability during pin and frame placement

– Avoid soft tissue impingement- stab incision, between muscle bellies

– Proper pin insertion technique- pre-drill if possible, avoid insertion wabble, low speed   drill to prevent thermal damage

– Engage pin in cis and trans cortex

– Smooth pins and negative profile pins inserted at 70 degree angle to long axis of bone

– Insert pins in same plane when using straight connecting bars

– Far near, near far configuration. Keep half bone diameter or 3 x implant diameter from   fracture edge.

– 3-4 pins in each fragment

– Appropriate choice of pin and connecting bar diameter. Pins no more than 20-25% bone diameter

– Optimise distance from connecting bar to skin. Shortest working distance of pins.

– Bone graft if defects

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