External Skeletal Fixators Flashcards
what is an ESF?
- external skeletal fixator (aka ex fix)
- contraption: fixation pins penetrate skin and soft tissues and cortices of bones to be locked to an external connecting bar
what are advantages of ESF?
- affordable, reusable components
- closed or minimally invasive, bio friendly: applying from outside in and don’t enter the fracture zone itself
- improved access to wounds: open fractures
- ***can adjust stability for phase of healing! can easily remove
- minor procedure to remove
what are disadvantages of ESF?
- pins can cause soft tissue irritation
- possible avenue for infection (but usually able to wall off)
- not suitable for all bones or patients (ex femur has a lot of muscle, quads don’t want to be skewered w large pin)
- eccentric position of connecting bar is weak
- weekly post-op care is necessary
what are the 2 requirements for fracture healing?
- stability (mechanics)
- viability (biology)
T/F: an ESF can combat all fracture forces
true!
what are common indications for ESF?
- tibial fractures!! (good location and not a lot of tissue around it) and radius/ulna
- open fractures
- some mandibular fractures
- most fractures are suitable, depending on location
- exotics! birds!
what is a hybrid ESF?
combining ring with a linear fixation
T/F: ESF are often used for angular limb deformities (ALD)
true: great for them
what are used often in birds?
ESF: don’t want bulky implant interfereing with ability to fly or catch prey
T/F: you can shorten AND grow bone with ESF
true: ALD correction, and limb lengthening (distraction osteogenesis)
dialing nuts incrementaly over time can grow bone or can shorten it
what is distraction osteogenesis?
limb lengthening
what are ESF not great for?
- any fracture involving a joint (want to anatomically reconstruct)
- pelvic fractures
- upper limb (limited configurations)
- non-compliant owners
- fractious patients
what are the components of a linear exfix?
- fixation pins
- connecting clamps
- connecting bars
how do you classify fixation pins?
- half pin: comes in from one side and thru bone but doesn’t penetrate the opposite side
- full pin: goes through full leg and threaded in the middle
what are tapered run out pins?
have threaded loop; pins with the taper are less prone to having stress rises so we use those
