|War Wounds with Fractures: A Guide to Surgical Management (ICRC, 1996, 64 p.)|
|Chapter 5 APPLICATION OF EXTERNAL FIXATION|
Before applying an external fixator make sure that the necessary equipment and components are available and in good order. It is particularly important that drills and pins are sharp, and that their size and that of any drill guides match the manufacturer's specification. Familiarity with the equipment and its application is essential: consult colleagues and manuals before starting. Without taking all these precautions, the procedure is likely to fail.
The best system is one which allows free placing of the pins. The pin positions should not be determined by the frame.
A number of commercial systems are available and simple ones can be created using wood or metal components joined with plaster bandages or bone cement. However, "home-made" systems tend to be only of short-term value as they fail when the patient is mobilized. A simple but versatile commercial system should be available which allows application of the pins, manipulation and holding of the fracture by the surgeon and then tightening of the components of the frame by an assistant.