– External Fixation Main Menu – Discussion: – disadvantages of external fixation: – pin tract infections, delayed union / non-union, and malunion; – cosmetic problems; – advantages of external fixation: – technically easy to perform; – no soft tissue stripping; – ease of removing hardware; – comparison of IM nailing vs external fixation – Initial … Read more
– See: – Over Distraction of Wrist Joint – Palmar Tilt Reduction – Radial Inclination Reduction – Wrist Position: – wrist is placed in neutral to slight extension w/ care taken not to over distraction the hand; – over distraction is related … Read more
– Metacarpal Incision: – always performed first, to ensure proper length of fixator; – make longitudinal incision from base of 2nd metacarpal to its midshaft; – terminal branches of radial sensory nerve can be identified & carefully retracted; – dissect down to bone, and insert … Read more
– See: Internal Rotation – Discussion: – external-rotation laxity increases w/ knee flexion, w/ largest amount (20 degrees) being seen in the 30-40-deg range of flexion; – external rotation is not directly limited by cruciate ligaments; – only PCL, which becomes taut at 90 deg of flexion, would be expected to … Read more
– Location of Pin Insertion Sites: – depending on type of frame used, at least two or three pins are placed along iliac wing; – 1st pin is usually placed about 2 cm posterior to anterosuperior spine. – rest of pins should then be placed along iliac crest using … Read more
– See: Over Distraction of Wrist – Discussion: – patient is instructed to move all unaffected joints throughout the joint; – avoid pronation and supination of forearm since this applies skin tension over most proximal screw; (infection is most common here); – when limited finger or … Read more
– Mid-Shaft Humeral Fractures: – consider screw placement in the short frx segment first, since the longer fragment will be more forgiving for shorter or longer screw placement; – take care to avoid injury to axillary nerve proximally and the radial nerve distally; – proximal pin … Read more
– General Fixator Considerations: – fracture healing: – references: – Comparison of osteotomy healing under external fixation devices with different stiffness characteristics. – External skeletal fixation of canine tibial osteotomies. Compression compared with no compression. – Comparison of the effects of compression plates and external fixators on … Read more
– Discussion and Indications: – definitive stabilization of frx may be achieved w/ external fixation in certain rotationally unstable but vertically stable injuries; – relative contraindication is iliac wing fractures; – antero-posterior compression injuries: – external fixation is most applicable to stable “open book” … Read more
– See: Extensor Tedon Lacerations – Discussion: – tendon laceration is usually transverse w/ minimal retraction; – often extends into the PIP joint; – lateral bands are often spared, but may be subluxed volarly due to disruption of the triangular ligament; – left untreated, a boutonniere injury … Read more