External fixators

 

Like plates/screws, external fixators can provide strong support for very unstable broken legs. They have the advantage of minimal tissue disruption which allows for rapid healing and are commonly used in areas where there is less muscle coverage (e.g. tibial or radial fractures).

 

Unlike plates or pins, part of the external fixator sits outside the body – pins run from the bone to outside the skin where they connect to a weight bearing rod. It is basically like a scaffold. It seems pretty odd at first and can owners feel a little queasy. These frames also have to protected from getting caught around the house, and vice versa. They are incredibly well tolerated by the patient despite looking rather odd.

 

Contaminated fracture sites where lots of debris has gone in the wound, or the bone has broken through the skin are well suited to this technique. They are also incredibly useful when there has been significant skin damage. A plate cannot be used if it cannot be covered by skin.

 

In my early career at the PDSA we did not have the finance to have lots of plates and screws so I virtually always used external fixators whilst now I would also choose a plate whenever possible.

 

The broken tibia on the left had so many breaks in so many directions that a fixator was the perfect method.

 

A pin down the centre of the bone was used to get the length and alignment before the frame secures the pieces in the right spot.

 

 

 

 

 

 

 

 

Another example of external fixation with a pin is the case on the left shown immediately after surgery.

 

This cat had not only broken the femur or thigh bone , but then when escaping from his cage at home he damaged it further.

 

It splintered going towards the knee. When I tried to use the pin to get it to the right length, the pin tended to push through the bone rather than pushing it to the correct length.

 

I used the external fixator pins to pulls the thigh bone back to the correct length.

 

Once it was locked in place,the pin down the centre of the femur was locked to the fixator.

The picture on the right was taken just 7 weeks after surgery. Healing progressed incredibly quickly  despite the horrible fracture.