FOR AO ORP 2010: Participant in 45th AOTrauma ORP Course-Principles in Operative Fracture Management 2011-2015:Table Instructor 2010-2011: AOTrauma ORP Program Development Taskforce, Zurich, Switzerland 2015: AO educator course

Office : Orthopaedics Operating Room , Siriraj Hospital , Mahidol University , Bangkok

Education 2007: Bachelor degree in Nursing, Faculty of Nursing, Mahidol University 2014: Master Degree of Art in English for Careers, Language Institute, Thammasat University Pranom Thapthimthong

The Large External Fixation System

Objectives

• Understanding the principle of external fixator

• Illustrating the types of external fixator

• Describing the implants and functions

• Explaining the instruments and using process

Definition

An external fixator is a device

placed outside the skin which

stabilizes the bone fragments

through wires or pins connected

to one or more longitudinal

bars/tubes

Indications

• Polytrauma patients

• Severe opened fracture

• Closed fracture with severe soft tissue

injury

• Open fracture involving bone loss

• Pelvic ring disruptions

Indications

• Infected nonunion fracture

• Limb lengthening

• Bone transportation

• Arthrodesis

• Intra-operative reduction

Types of External fixator

. Ring fixator . Tubular fixator

. Hybrid fixator

Three Basic Types of The AO External Fixator

Type III Triangular frame

Type I Unilateral frame

Type II Bilateral frame

One – plane frame

Unilateral

Two – plane frame

Bilateral Frame One Plane

Modular External fixator

12 AOEA

Implants

Schanz screw 5.0 mm

Self Tapping (predrilling)

Schanz screw 5.0mm Self drilling self tapping

Drill

Tap

Screw

Stainless steel tube

Carbon fiber rod

Tube

Single adjustable clamp

Open adjustable clamp (Clip-on)

Open rod clamp

Tube to tube clamp

Universal joint for two tubes

Schanz

Rod

Transverse clamp

Multipin clamp for 2- 6 Schanz screw

Open compressor

Instruments

Universal chuck with T-handle

Drill bit 3.5 mm

Triple drill sleeve Drill sleeve short

Drill sleeve short Trocar short

6.0/5.0 5.0/3.5 3.5

Drill sleeve long Drill sleeve long Trocar long

6.0/5.0 5.0/3.5 3.5

Aiming device

Combination Wrench

Wrench

Socket Wrench

Depth gauge

Adaptor for selfdrill

Caps for tube and rod

Protective cap

Instruments for removal • Combination wrench, 11 mm. • Socket wrench • Universal chuck with T-handle

Thank you

Take home message for External Fixator

• Achieve relative stability

• Construct in various ways

• Preserve the soft tissue

around fracture sites

• Particularly useful in fracture

associated with extensive soft

tissue damage

Thank You

Thank You