Micro External Fixation: the “Do-It-Yourself” Method

James Fletcher, MBBS, BSc(hons), MRCS, John Grice, MBBS, MSc (SEM), FRCS,
and Simon Tilley, MBBS, BSc, DM, FRCS (Tr & Orth)

Key Words: external fixator—hand injuries—phalanx fractures.

(Tech Orthop 2015;30: 255)

A n inexpensive alternative to industry micro external fix-

ators can easily be made in the operative theater.
First cut the ends off of a 10-mL syringe (BD Sterifill
SCF). K-wires of 1.6 mm are inserted transversely through the
plastic of the syringe and then into the desired bone (Fig. 1).
Once all 4 wires have been placed, 1 mix of bone cement (eg,
PALACOS, Heraeus Kulzer GmbH) is injected into the syringe
and the surgeon’s finger is used to temporarily seal the other
end. After the syringe is filled, final positioning of the syringe
can be made before the long ends of the K-wires are cut
(Figs. 2, 3). This construct is inexpensive, less damaging to the FIGURE 2. Cemented construct.
extensor tendons compared with threaded pins, and it is much
easier to get good purchase in very small bones.

FIGURE 1. Wire placement. FIGURE 3. Position in vivo.

From the Weston General Hospital, University Hospital Southampton,

Weston-Super-Mare, Somerset, UK.
The authors declare that they have nothing to disclose.
Address correspondence and reprint requests to James Fletcher, MBBS,
BSc(hons), MRCS, Weston General Hospital, University Hospital
Southampton, Weston-Super-Mare, Somerset, UK. E-mail:
jwa.fletcher@doctors.net.uk.
Copyright r 2014 Wolters Kluwer Health, Inc. All rights reserved.

Copyright r 2015 Wolters Kluwer Health, Inc. All rights reserved.