You are on page 1of 2

Surgery External Fixateur Consists of three components: o The pins  Which enter through the skin and engage

the bone  Vary in shape and design and size • Smooth trochar pointed pins • End threaded negatively profiled pins • End threaded positively profiled pins • No point positively profiled end threaded pins o Connecting bar  Transmits the bulk of the forces  Vary in design and size and material  Rods may be stainless steel, titanium or carbon fibre • Carbon fibre and titanium = lighter • And carbon fibre is radiolucent o Clamps  Combine the first two  Vary in design: • K-E clamp • Secure as camp • Imex clamp

Application of Type 1a ex fix to tibia  1 connecting bar  6 positively threaded pins  6 I-K clamps  Combination wrench  Drill bit  Drill sleeve Anatomy of proximal tibia  Has a relatively thin cranial aspect, the tibial tuberosity  in cross section, is triangle in shape with majority of bone being palced caudally  in pin placement, engage maximum bone stock with pin  pin located towards caudal cortex will engage more bone Palpate landmarks of the proximal tibia: o Tibial tuberosity o Patellar tendon o Patella o Proximal aspect of tibia

make a 1 cm releasing incision through the skin until bone is encountered  Drill guide should be placed directly on bone and protect soft tissues When drilling:  Make sure parallel to joint surface and drilling in a medial to lateral direction  Pin is then placed through drill hole and inserted under slow speed  Following releasing skin incision.Tensing skin of proximal tibia. place most distal pin o must be drilled in a medio to lateral direction parallel to the joint. we need to tighten the clamps o Make sure the primary bolt is nearer to the bone than the secondary bolt o Clamp should be approx 1 cm from the skin so it will not impinge the soft tissue structures o The further the clamp will be. distal pin is now placed  Care is taken not to drill too quickly  Once placed most proximal and distal of pins. the mechanically weaker it will be  Primary bolt should be stabilized with a primary wrench while socket wrench can tighten it  Combination wrench can hold the clamp while the bolt is tightened  Now will place the third and fourth pins o Should be no closert than one bone diameter o First remove secondary bolt o It engages bolts  . identify position approximately 2/3 of the way to the caudal cortex  With the skin tensed. the connecting bar is then applied to the two pins  The SK clamp o Has a primary bolt which accepts the pin and a secondary bolt which tightens the clamp to the connecting bar o Connecting rod is placed through the hole o A second clamp is then placed on the rod o The pins are then placed through the primary bolt of the SK clamp o The clamps are then finger tightened o Once connected to the pins and connecting bar. the fracture can now be reduced in a closed fashion  Once reduced. being sure not to enter the joint itself  Similar to placement of most proximal pin.