Important Insights on External Fixator Systems

Important Insights on External Fixator Systems

The skeleton is the core component of our bodies since it not only allows us to move around but also gives us a solid foundation for doing all sorts of things. Gaining a grasp of the skeleton’s essential function is necessary for appreciating how bone ailments, such as fractures, affect muscle movement. 


When it comes to fractures, especially complex ones, traditional methods like orthopedic securing plates or casts may only sometimes be the optimal solution. This is where external fixators’ unique and versatile nature comes into play, making them a singular instrument that orthopedic surgeons often turn to. For instance, in open fractures where the bone has pierced the skin or in severe fractures involving multiple bone fragments, external fixators are usually the go-to solution. Let’s look into the intricacies of the external fixator system. 

Various designs of external fixators are available, determined by the fracture’s location and nature. There are frequent varieties of external fixators, like,

1. Bilateral fixator

When stabilizing a more complicated bone fracture, a double-sided fixator is utilized, which involves inserting pins or wires into the bone from both ends. This procedure, known as bilateral external fixation, is commonly used in orthopedic surgery. 

It involves making small incisions near the fracture site, inserting the pins or wires, and attaching them to the external fixator device.  

2. Unilateral fixator

This fixator is designed for more superficial fractures that can be stabilized with pins or wires placed from one side of the bone. It is a single-sided device.

3. Hybrid fixator 

This hybrid device, a testament to the adaptability of external fixators, incorporates features from many fixator types, providing the ability to adapt to different types of fractures. 

4. Circular fixator

This fixator goes around the whole bone piece and provides the most potent form of stability. It is most often used to fix broken bones, make artificial limbs bigger, and fix deformed bones. 

But it’s important to remember that using external fixators comes with risks and possible problems, just like any other surgery. These can include getting an illness, nerve damage, or needing more surgery. 

What are the components of External Fixator Systems?

An external fixator system is a medical apparatus to stabilize and align shattered or broken bones. A regular cast or plate is put inside the body. On the other hand, an external fixator is applied externally, which means it sits on top of the skin. The external fixator system consists of three primary components: 

Pins or wires

These slender, filamentous metal pins or wires are directly placed into the bone pieces on both sides of the fracture. 

Rods or bars

 These inflexible rods or bars establish a secure framework outside the body by connecting the pins or wires. 


Clamps are used to fasten the pins or wires to the rods, enabling the necessary modifications in bone alignment during the healing phase. 

Why Are External Fixator Systems Necessary? 

Many orthopedic trauma and reconstructive surgeries depend on external fixator devices. Indications for external fixator systems in clinical practice are as below.

  • External fixators assist in the stabilization of open fractures, particularly those with a high risk of infection. They do this by providing a rigid frame that holds the fractured bone in place, while also permitting access to wound treatment.
  • When internal fixation is not possible because of significant soft tissue damage, external fixators provide stability without putting soft tissue integrity at further risk.
  • Patients with multiple injuries requiring immediate stabilization benefit from the life-saving use of external fixators, which can be swiftly administered in emergency situations, potentially preventing further complications and saving lives.
  • Distraction osteogenesis and similar procedures employ external fixators, known for their precision and effectiveness, to correct deformities and progressively lengthen bones, providing a reliable solution for these complex cases.
  • Using external fixators in osteomyelitis or nonunion provides stability and streamlines the process of administering local antibiotics and grafting bone while preventing infection.

Explain Surgical Techniques

External fixators provide adaptable and efficacious resolutions for the management of intricate fractures and the promotion of bone regeneration.  External fixators must be applied in accordance with these steps which are mentioned below.

Step 1: Pinning placement and frame configuration, customized to the particular fracture or deformity, must be determined with precise preoperative planning.

Step 2: Wire or pin insertion, It is critical to avoid neurovascular structures when inserting wires or pins into the bone. Frequently, this is achieved with fluoroscopic guidance.

Step 3: Building the external frame follows the installation of the pins. Modular systems permit configurations that are tailored to the specific requirements of each patient.

Step 4: Regular follow-up appointments are required to fine-tune the frame and track the progress of bone healing. As necessary, adjustments may be implemented to rectify misalignment or extension of the bone.

Management of Complications

Although external fixators are extremely helpful in managing fractures, they are associated with some risks.


In order to avoid infections, sterilization of equipment must be done properly, and carefully checking pin sites must be done.

Nerve Injury

Minimizing the danger of nerve injury is possible with proper pin placement and imaging procedures.

Bone and Joint Difficulty

Regular physiotherapy and regulated movement exercises are helpful in avoiding joint stiffness.

Breakdown of Hardware

You can avoid hardware failure by checking and maintaining the fixator regularly.

Wrapping It Up

Orthopedic surgery relies on external fixators to stabilize and repair complicated fractures. For the best results, patients should see surgeons who have expertise in all the number of fixators available, how to choose the right one, proper surgical technique, and possible risks. Advancements in fixator design and materials consistently improved the safety and effectiveness of these very important medical devices, leading to better patient care and recovery.

Renowned for its commitment to precision, innovation, and perfection, Uteshiya Medicare is a leading orthopedic implant manufacturer. Uteshiya manufactures high-grade orthopedic implants, such as advanced external fixator systems, using the latest technology. Their dedication to research and development ensures that healthcare providers receive reliable and effective bone repair and rebuilding products. 

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