Pitfalls in the management of open fractures with Hoffmann external fixation

There have been many improvements made in external fixation, and fixators are being applied with renewed enthusiasm. Inspite of advances in design and application, complications related to the treatment of open fractures are still frequent. Although external fixation has dramatically improved the treatment of open fractures and made possible the salvage of previously amputated limbs, it is a complex technique with many pitfalls. These problems fall into two broad categories: those related to the application and maintenance of the pins and frame on one hand, and those related to the management of soft tissue and bony injuries on the other.