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External Skeletal Fixator (ESF) (Frame Stiffness (Pin factors (Number,…
External Skeletal Fixator (ESF)
ESF
Percutaneous pins
Pass into or through bone
Connected together externally
Clamps & rods
Acrylic bars
Epoxy putty
Advantages
Versatile
Easy to apply
Visual
Compatible with biological osteosynthesis
Maintain aligment and length of limb
Disturb fracture fragment minimally
C;psed or minimally invasive applicaiton
All fracture forces neutralised
Encourages early weight bearing
Frame designs
Original classification
Type I (Simplest
Type 2 (Complex)
Descriptive classification
Location of pins & connecting bars
Unilateral frame (Type 1)
Half pins
Through bone but not out of leg
Easiest to apply but weaker
Bilateral frame - Uniplanar (Type 2)
Uses full pins
Exits leg
Modified type 2 (LHS)
Mix of full and half pins
Less complex
Bilateral frame - Biplanar (Type 3)
Rare
Type 2 - medial to lateral
Type 1 cranial
Requires lots of pins
USe when suspect prolonged support necessary
Ilizarov
Ring fixator
Correct angular limb/rotational forces
Fixator Pins
Smooth pin
Held in by friction only
Negative Profile Thread
Good bone purchas
Weak point mus tbe protected
Want it in medullary canal
Posotive Profile Thread
Excellent purchase
No weak point
Must pre-dill a pilot hole
Pin clamps
Connecting bars
Stainless steel
Carbon fibre
Not as strong but allow x-rays
Frame Stiffness
Frame geometry
Pin factors
Number
Type
Placement
Clamp factors
Type
Orientation
Fracture configuration
Load sharing with frame
Combinaiton fixation
