Hand & Wrist Care With External Fixation

External Fixators

An external fixator acts as a stabilizing frame to hold the broken bones in proper position. In an external fixator, metal pins or screws are placed into the bone through small incisions into the skin and muscle.

The pins and screws are attached to a bar outside the skin. Because pins are inserted into bone, external fixators differ from casts and splints which rely solely on external support.

In many cases, external fixation is used as a temporary treatment for fractures. Because they are easily applied, external fixators are often put on when a patient has multiple injuries and is not yet ready for a longer surgery to fix the fracture. An external fixator provides good, temporary stability until the patient is healthy enough for the final surgery.

Other times, an external fixator can be used as the device to stabilize the bone until healing is complete.

There may be some inflammation or, less commonly, infection associated with the use of external fixators. This is typically managed with wound care and/or oral antibiotics.

External fixation is often used to hold the bones together temporarily when the skin and muscles have been injured.

Care for External Fixators

Your Wisconsin Bone & Joint doctor may recommend different cleaning techniques or solutions depending on the type of external device and the extent of your injury or fracture. In any case, use common sense with your external fixation device.

  • Wash your hands well and often before cleaning your pin sites or the device.
  • Be gentle and thorough, and dry everything carefully.
  • The cleaning process should be followed routinely even if your doctor has prescribed antibiotics as a preventative measure.
  • Since you’ll be cleansing your pin sites and the device twice a day, it may make the most sense to gather everything you’ll need and keep it handy and dry in a central location.
  • You’ll need cleansing solution (sterile water), disposable cups, sterile cotton swabs, sterile gauze pads (in two-inch and four-inch squares) and a small trash bag to dispose of soiled gauze pads and swabs.
  • After washing and drying your hands thoroughly – towel and discarding it after use – use your fingertips to lightly touch and press the skin around the pins. This will encourage any drainage to come to the surface. Use a cotton swab saturated with cleansing solution to remove any crust or drainage from the pin sites.
  • Always work in a gentle, circular motion,moving away from the site.
  • Use a fresh swab for each pin site.
  • Use a fresh two-inch sterile gauze pad to clean each pin.
  • For the first few days, your doctor may advise you to wrap sterile gauze around each pin site.  Once no further drainage is present, the pin sites may be left uncovered.
  • Use cotton swabs and the larger gauze pads to clean the entire fixator device carefully.
  • Dispose of all the soiled swabs and pads.Wash and dry your hands thoroughly.
  • Take a shower.
  • After 10 days or so (your doctor will advise you), you may be allowed to shower with your external fixator.
  • Dry the fixator thoroughly with a clean towel and follow all other cleaning instructions for the pin sites.

Be sure to talk with your doctor if you have any questions on how best to care for your fixator and the pin sites.

What are the symptoms of infection?

No matter how carefully you’ve looked after your pin sites, an infection is still possible. Contact your WBJ doctor immediately if you observe redness or swelling at the pin site, thick or colored discharge, tenderness or pain, or any wiggling, play or movement in the pins.

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