[External fixator: surgical technique, pinless fixator, change in procedure]

Area of Science:

• Orthopedic surgery
• Biomedical engineering

Background:

• External fixation provides advantages over internal fixation, including preserved blood supply and adjustability.
• However, long-term external fixation is associated with pin complications and delayed fracture union.

Purpose of the Study:

• To detail the technique of external fixation for tibial fractures.
• To highlight methods for reducing pin complications and improving fracture healing.

Main Methods:

• Utilizes a unilateral fixator with Schanz screws inserted into bone fragments.
• Employs low-temperature drilling and preload application to minimize pin-bone interface issues.
• Fracture reduction is achieved using connecting tubes, allowing for three-dimensional alignment corrections.

Main Results:

• Proper technique can reduce pin complications like infection and loosening.
• Controlled motion at the fracture site around three weeks post-injury can stimulate callus formation.
• Pinless fixators offer an alternative by clamping bone without medullary canal contamination.

Conclusions:

• Optimized postoperative management and improved screw designs are crucial for successful external fixation.
• Addressing the pin-bone interface is key to minimizing complications.
• Techniques for secondary correction and controlled dynamization aid fracture healing.