How To Use External Fixators To Treat Fractured Heels?

External fixation is a surgical procedure that involves placing pins or screws into the bone at various points, typically above and below the fracture. These pins are secured together outside the bone. An external fixator is a stabilizing frame that holds broken bones in proper position, allowing them to be reset or realigned correctly while allowing movement of nearby joints. This can help minimize complications such as muscle damage. Indications of external fixation include open fractures, closed fractures with high grade soft tissue injury, vascular injury with acute repair, and multiple long bone fractures in critically injured patients.

Orthopaedic surgeons at trauma centers should be familiar with the techniques and principles of external fixation for various upper fractures. An external fixator is a metal frame that keeps bones in place, with pins from the ex fix inserted through the skin and into the bones to help them heal. Debridement removes dead and infected tissue, including bone, and the fracture is temporarily stabilized by external fixation. Final osteosynthesis is done using adjustable rods.

External fixators have adjustable rods to help lengthen the bone. Follow your orthopaedic team’s instructions for turning the struts daily and attend physical therapy for the injured. When a heel fracture doesn’t affect the joint and the broken pieces aren’t displaced, it may be treated with nonsurgical management, including rest, icing, compression, and external fixation.

The goal of surgery for a calcaneus fracture (broken heel) is to restore the shape and alignment of the heel bone as close to normal as possible. The external fixator provides stability to the fragments via smooth and olive wires, making the final construct stable.

How to dress with an external fixator?

The initial phase of the procedure entails the placement of a non-adherent form over the incision sites, followed by the application of ABD coverage and the subsequent unrolling of multiple Curlex rolls to guarantee optimal coverage.

Can you walk with an external fixator on foot?

A significant number of patients are permitted to bear weight as tolerated with the external fixator, thereby enabling them to ambulate in a manner that approximates normalcy, though they are advised to refrain from activities such as running or jumping. The aforementioned devices can be observed at the West Palm Beach Clinic, situated at 901 45th Street, Kimmel Building, West Palm Beach, Florida, 33407.

When should external fixators be removed?

The TAYLOR SPATIAL FRAME device is removed after X-ray examinations demonstrate complete healing of the consolidated bone. This is typically conducted under general anesthesia as an outpatient surgical procedure. Subsequently, a brace or cast may be utilized to facilitate the healing process of the bone. It is possible that some physical limitations may occur initially, and it is therefore advisable to consult your surgeon about these limitations.

How painful is external fixator removal?

After fixator removal, there should be minimal pain and any discomfort before the procedure should subside. Pain-relieving medication like acetaminophen or ice can be used. Crutches can be used as desired, and a cast or splint may be necessary for a few weeks. Exercise is important, but avoid twisting, jarring, or heavy work. Good exercises for increasing range of motion include swimming, walking, biking, and stretching. If any issues arise, contact Telehealth Nursing at 651-229-3890.

Can you wear shoes with an external fixator?

To prepare for physical therapy, consider various options such as side-snap nylon sports pants, sweat suits, bell bottoms, and modified clothing. Underwear should be adjusted if the apparatus will be on your leg, such as oversized “petti pants” or French cut, thong, or bikini underwear. Bathing suits for the physical therapy pool should be modified, with two-piece suits being easier to get on and off. Shoes with good traction should be brought for use during physical therapy, and low-cut shoes may be used depending on the doctor’s placement of the fixator on your leg.

Coats can be used to keep the arm warm during winter, such as a shawl or cape. External fixator covers are primarily decorative but can also be used to avoid stares and questions in public, keep small children’s fingers away from the fixator and pin sites, and provide warmth during colder months.

It may be better to make the covers after surgery to take accurate measurements, as fixators come in a variety of shapes and sizes. It is essential to bring shoes with good traction for use during physical therapy, and to bring a shawl or cape for the arm.

What is the most serious disadvantage of external fixator?

External fixation treatment can lead to complications such as pin site infection, osteomyelitis, frame failure, malunion, non-union, soft-tissue impalement, neurovascular injury, and compartment syndrome. Despite changes in application and devices, the biomechanics of external fixation remain consistent. This activity outlines anatomy, techniques, fixation goals, and the interprofessional team’s role in managing patients undergoing external fixation, identifying indications and contraindications, and describing equipment, biomechanics, and techniques.

How to sleep with an external fixator?

It is recommended that patients sleep on their backs, and that an external device be used to elevate the affected limb for comfort and security. Furthermore, it is advised that the fixator frame cover be worn during sleep to prevent sheet rips.

How long does external fixator take to heal?

External fixation is a procedure that sets and immobilizes a fractured bone in its correct alignment to facilitate adequate healing of the lower leg. It is performed in an operating room under general anesthesia and involves drilling small holes into uninjured areas of bones around the fracture and screwing special bolts or wires into the holes. Outside the body, a rod or curved piece of metal with special ball-and-socket joints joins the bolts to form a rigid support.

The fracture can be set in the proper anatomical configuration by adjusting the ball-and-socket joints. After the rods are fixed, regular cleaning is necessary to prevent infection at the surgery site. Most lower leg fractures heal between 6 and 12 weeks. After removal, a comprehensive and prolonged course of physiotherapy is necessary to maximize the procedure’s success and ensure full or near-full function in the lower leg post-fracture.

What are the disadvantages of external fixators?

External fixators are hardware used to hold broken bones together, unlike internal fixation methods like pins, plates, and screws. They are minimally invasive and usually require general anesthesia. The surgeon drills holes into undamaged bone and installs bolts, connected to rods attached to a frame outside the skin. These bolts are connected to rods attached to a frame outside the skin. External fixators may be used for fracture stabilization in cases of severe swelling at the injury site or anticipated swelling. In selected cases, external fixation frames may be used until the fracture is healed, which can take weeks to months.

What is the success rate of the external fixator?

A study involving 87 patients with open segmental tibial shaft fractures treated using a simple external fixator found that successful union was achieved in 97. 3% of cases. The average healing period was 23. 1 ± 3. 2 weeks, with 71 cases with normal healing and 34 cases with delayed union. Nonunion was seen in 5 cases and malunion in 3 cases. Orthopaedic complications included 30 cases of pin-track infections and 2 cases of osteomyelitis. Pin site infections were treated in 21 cases, and 5 cases required reoperations for nail or external fixator changes.

Two cases with osteomyelitis required multiple-bone debridements, while another two required multiple debridements of soft tissue. General complications included fat embolism, pulmonary embolism, and deep venous thrombosis in 11 cases. At the final follow-up, proper alignment was achieved in 107 cases, with 2 instances of malunion and one case of hypertrophic nonunion. No restrictions were observed in knee and ankle joint movement and pain at the final follow-up.

What precautions should you take when using an external fixator?

To clean pins, follow the care team’s instructions and avoid touching one pin with another to prevent infection. Use sterile gauze soaked with saline around the pin site and let it sit for a few minutes. Use separate gauze for each pin site. Once the crusting is softened, remove it with a cotton swab or alcohol-cleaning tweezers between each pin. Avoid letting anything touching one pin touch another, including gloves, gauze, tweezers, cotton swabs, and other items.