External Fixation
An external fixator holds a fracture with pins passing through the skin into the bone, connected to a frame outside the limb. It is used where the soft tissues are too damaged for internal fixation, and often as a first stage before definitive surgery later.
- Used when soft tissues are too damaged
- Often a first stage, not the final treatment
- Allows wound access and dressing
- Pin site care is the main task at home
Stay
Varies with the injury
Duration
45 to 90 minutes
Anaesthesia
General
About External Fixation
In open fractures and severe injury, placing a plate under damaged skin invites infection. An external fixator stabilises the bone while leaving the wound accessible for dressing and further surgery. Sometimes it is temporary, converted to internal fixation once the soft tissues recover. Sometimes it is the definitive treatment, particularly in complex or infected cases.
- Avoids placing metal under damaged skin
- Frequently a temporary first stage
- Leaves wounds accessible for dressing
- Pin site infection is the main risk and is largely preventable
Before you read on
Everything here is general information about external fixation. Whether it suits you, and how it would be done in your case, is a decision for your doctor after examining you.
Your consultant's instructions always take precedence over anything written on this page.
When is it recommended?
Situations in which a doctor may suggest external fixation.
- Open fractures with wound contamination
- Severe soft tissue injury around a fracture
- Polytrauma needing rapid stabilisation
- Infected fractures or infected metalwork
- Fractures that have failed to unite
- Limb lengthening and deformity correction
Procedure details
The usual sequence, from first consultation through to follow-up.
Wound care first
In open fractures, the wound is cleaned thoroughly and dead tissue removed before any fixation is applied.
Applying the frame
Pins are placed into the bone away from the injured area and connected to an external frame, aligning the fracture.
Ongoing wound care
The frame leaves the wound accessible, so dressings and further procedures can be done without disturbing the fixation.
Definitive plan
Once soft tissues recover, the frame may be converted to internal fixation, or kept until the fracture unites.
How to prepare
What to sort out before you come in.
- Usually applied as an emergency after significant injury
- Tell the team about diabetes and smoking, both of which affect healing considerably
- Prepare for a longer treatment course than a simple fracture
- Arrange help at home, as the frame is bulky and restricts clothing and movement
- Ask to be taught pin site care before discharge
Recovery
What to expect afterwards, and roughly when.
- Pin site care is the main daily task and prevents most complications
- Some pin site discharge is expected; increasing redness, pain or fever is not
- The frame is bulky and requires adapting clothing and sleeping arrangements
- Duration varies from weeks to months depending on the plan
- Removal is usually straightforward and often done without general anaesthesia
Why choose Humayun for external fixation
External fixation succeeds or fails on wound care and pin site hygiene rather than on the frame itself.
- Thorough wound debridement first, because fixing a contaminated fracture without cleaning it fails
- Pin site care taught properly before discharge, since it prevents most complications
- A clear plan stated at the outset for whether the frame is temporary or definitive
- Plastic surgery in the same hospital where soft tissue cover is needed
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