V a method of immobilizing

bones to allow a fracture to

heal.
V accomplished by placing pins
or screws into the bone on
both sides of the fracture.
V he pins are then secured
together outside the skin with
clamps and rods. he clamps
and rods are known as
theÚ
  

V can also be indicated for bony

non-union if fracture healing
has not been successful.
Ô tremities Face

Pelvis Jaw
F
i dibs
n
g
e
r
s


o
e
s
V {llows clients to use contagious
joints while the affected area
remains immobilized.
V supports areas with tissue or bone
infections.
V maintains position for unstable
fractures and for weakened muscles
V it is quickly and easily applied.
V he risk of infection at the site of the
fracture is minimal.
V Àeticulous pin insertion technique and skin
and pin tract care are required to prevent pin
tract infection.
V he pin and fi ator frame can be mechanically
difficult to assemble by the uninitiated
surgeon.
V he equipment is e pensive.
V he frame can be cumbersome, and the patient
may reject it for aesthetic reasons.
V Fracture through pin tracts may occur.
V t is difficult to do delicate surgery such as skin
flaps once the e fi apparatus is in place. dather do
this type of surgery before the frame is applied.
V de fracture after e fi removal may occur unless
the limb is adequately protected (e.g. by walking
cast application), until the underlying
V bone can again become accustomed to stress.
V he noncompliant patient may disturb the
appliance adjustments.
V he head injured patient may injure himself by
thrashing his pin studded limb against other parts.
V Joint stiffness may occur if the fracture requires
that the fi ator immobilize the adjacent joint. e.g.
an e fi placed over the ankle for a pilon fracture
as there was insufficient space for pins in the distal
tibial fragment.
V here are many potential complications with
sepsis being the most common.
V O



V   
.

V À 

 
.
V a

.
V x 

 
V .
{ Ô

V eurovascular {ssessment
-compare the affected
e tremities to unaffected
e tremities
V Pain and bleeding
V igns of infections
-assess pin sites
V utritional tatus

-Pay attention to the adequacy of

food intake, ability to eat and
swallow
V {bnormal laboratory values should
be determined
V {dminister antibiotics
V Wound care
- may involve wet to dry dressing
- presence of loosen pins must be
reported
V {ssess adherence to any weight
bearing restrictions and correct use
of ambulatory aids
V {dminister antiemetic agents as
ordered
V Client and family education
- Client should have begin to
accept change in body image that
accompanies use of e ternal
fi ation by the time of discharge
- Client should be responsible for
pin and wound care
- Client should be aware for sings of
infections, neurovascular changes/
integumentary changes
- Client should be instructed about the
use of antibiotics and analgesics
- {lternative methods of pain
management
- Visualization
- Àassage
- Distraction
- each client about good
hygiene
- deduce intake of gas forming
foods which can lead to
abdominal distention
- Once affected bone is healed,
fi ator is removed.
 {





O
 




  






  



 





  



 

 


  

 



 
 



 





 

 





  




V î 

-he more soft tissue there is, the greater is the chance for sepsis.
ite the pin where the bone is as superficial as possible.
V î


-Place the pin so as not to tension the skin. Close wounds, if
possible before inserting the pin, as closure will be likely to move
the skin. Àake rela ing incisions to relieve skin tension - suture
the resulting defect if necessary.
V   


-Drilling wide diameter pins directly into bone will generate heat,
this may lead to sequestrum formation and sepsis. Ôither pre drill
the pins with a helical drill, or use hand instruments to insert the
pin.
V O
x
-nadequate pin care and poor hygiene may lead to sepsis
V Clean the skin / pin interface of all discharges
twice daily
V {ntiseptic dressings - "Betadine" (povidone)
ointment
V nflamed Õ
 skin about a pin  Õ

ÕÕ -
 Õ   (oral) antibiotic
V eptic ^ O
- remove, and replace with
another through normal skin
 Prepared by

Àa. Glory Fel Ô. Àapa

Zarah Jean O. Àasote
atalie Young Àacayan
Frances Àagno

B  3B