Internal fixation of fractures and beginning of external fixation

Question 1

Describe External skeletal fixation

Answer 1

Pass pins from outside the body and through both cortices of the bone in a transverse fashion
these fixation pins are then attached to atleast one external connecting bar

Question 2

What forces are ESF good at controlling?

Answer 2

All forces

Question 3

Old people call external skeletal fixator a what?

Answer 3

K-E apparatus

Question 4

Do all ESF use metal clamps and connecting bars?

Answer 4

No

Question 5

3 components of ESF

Answer 5

transfixation pin
clamp
connecting bar

Question 6

3 components of ESF

Answer 6

transfixation pin
clamp
connecting bar

Question 7

Which part of ESF goes intot he actual bone

Answer 7

Transfixation pins

Question 8

If you use non threaded pins what are you supposed to do?

Answer 8

Angle them relative to eachother so they are harder to pull out

Question 9

Differentiate negative and positive profile pins

Answer 9

.

Question 10

Which is stronger positive or negative profile pins?

Answer 10

Positive

Question 11

2 types of transfixation pins?

Answer 11

Half pin

Full pin

Question 12

Does the pin have to penetrate both cortices?

Answer 12

Yes fully penetrate both cortices

Question 13

Clamps are tightened with a?

Answer 13

Crescent wrench

Question 14

What can you use instead of a clamp?

Answer 14

Wad of epoxy or something that hardens

Question 15

What is the advantage and disadvantage of connecting bars?

Answer 15

Advantage : adjustable after you have it in place

Disadvantage: pins have to be in a straight line and of similar size

Question 16

The minimum number of fixation pins that should be placed in the most proximal and distal fragments is?

Answer 16

3

Question 17

Describe a type 1a fixator

Answer 17

unilateral uniplanar fixator

Weakest but most common

Question 18

Describe a type 2 fixator

Answer 18

Bilateral uniplanar fixator

Question 19

Describe a type 1b fixator

Answer 19

unilateral biplanar fixator

Question 20

Why is the type 1b so common?

Answer 20

Very strong and no medial bar which means it can be used on the humeral and femoral fractures where the torso is medial

Question 21

Describe a type 3 fixator

Answer 21

Bilateral biplanar fixator
90 degrees to eachother
too strong, bones don’t reform

Question 22

Want to make ESF stronger? Do what?

Answer 22

Connect the bars to eachother all the way through.

Question 23

What is a type 1b fixator

Answer 23

unilateral biplanar fixator

Question 24

What is a type 2 fixator

Answer 24

Bliateral uniplanar

Question 25

What is an IM pin ESF tie in?

Answer 25

Combined IM pin and ESF
Join the IM pin to the connecting bar
much stronger and fewer transfixing pins

Question 26

What is an IM pin ESF tie in?

Answer 26

Combined IM pin and ESF
Join the IM pin to the connecting bar
much stronger and fewer transfixing pins

Question 27

When do we typically use transfixation casts?

Answer 27

Large animals to prevent compression

Question 28

When do we typically use transfixation casts?

Answer 28

Large animals to prevent compression

Question 29

What comprises circular external skeletal fixation?

Answer 29

Rings clmaps and wires that are very taught at 90 degrees to eachother

Question 30

What part of circular external skeletal fixation stimulates bone healing

Answer 30

small amount of bounce that it has

Question 31

Best time to use circular external skeletal fixation?

Answer 31

Short proximal or distal fragments to be dealt with

Question 32

If ESF is only fixation how man pins per major fragment?

What about with IM pin?

Answer 32

3 through both cortices

1-2 pins per main fragment

Question 33

Do transfixation pins ever not penetrate both cortices/

Answer 33

NO

Question 34

Positive profile pins need what done prior to putting them in

Answer 34

Need to pre drill a hole

Question 35

5 advantages of ESF

Answer 35

Minimal blood supply disruption
HArdware removal may not require GA
Fixator removal can be done in stages to gradually transfer forces back to the limbs
Can be used in highly comminuted fractures
Good to deal with short proximal or distal fragments

Question 36

5 advantages of ESF

Answer 36

Minimal blood supply disruption
HArdware removal may not require GA
Fixator removal can be done in stages to gradually transfer forces back to the limbs
Can be used in highly comminuted fractures
Good to deal with short proximal or distal fragments

Question 37

2 Disadvantages of ESF

Answer 37

Not so hot for proximal large bones

Hardware removal required

Question 38

ESF is a good choice for? (5)

Answer 38

Open fractures or degloving injuries
highly comminuted fractures
fractures with short proximal or distal fragments
stabilization of corrective osteotomies
distraction osteogenesis