Application and postoperative management of external skeletal fixators.
Application of external skeletal fixation involves preoperative assessment of the fracture with regards to healing potential of the bone and stabilizing requirements of the fixator. The fixator can be used alone or with supplemental (IM pin, cerclage, hemicerclage, Kirschner wires, bone screws) fixation to counteract shear, bending, and torsional forces at the fracture site. In addition, cancellous bone grafting can be used to enhance fracture healing. Rigid frames should be based on predrilling pilot holes followed by slow speed or hand insertion of smooth and threaded pins. Precise knowledge of regional anatomy precludes iatrogenic neurovascular or muscular tissue damage, which, subsequently, improves patient morbidity. Postoperative care of the fixator consists of bulky wraps to control pin-skin motion and cleaning of pin tract drainage sites. "Dynamization" or bone loading can be performed during fracture healing to stimulate osteosynthesis. This involves staged disassembly and reduction of frames by removing pins and connecting rods.
Aron
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DN
Department of Small Animal Medicine, University of Georgia College of Veterinary Medicine, Athens.
Dewey
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CW
D000818:Animals; D001858:Bone Nails / Q000662:veterinary*; D016267:External Fixators / Q000662:veterinary*; D005264:Femoral Fractures / Q000601:surgery / Q000662:veterinary; D050723:Fractures, Bone / Q000601:surgery / Q000662:veterinary*; D006810:Humeral Fractures / Q000601:surgery / Q000662:veterinary; D011182:Postoperative Care / Q000662:veterinary*; D011885:Radius Fractures / Q000601:surgery / Q000662:veterinary; D013978:Tibial Fractures / Q000601:surgery / Q000662:veterinary; D014458:Ulna Fractures / Q000601:surgery / Q000662:veterinary