FRACTURE MANAGEMENT: PRINCIPLES OF EXTERNAL SKELETAL FIXATION

The External Skeletal Fixation (ESF) system integrates the use of transfixation pins, an external frame, and sometimes a "tied-in" intramedullary pin for orthopedic fixation. Use of the ESF system may be in conjunction with interfragmentary fixation techniques such as cerclage wires, lag screws, and K-wires when appropriate. Bone plate and screw fixation is another example of an implant system used for similar indications including fracture management, corrective osteotomy, and arthrodesis. Neither the plate & screw system, nor the ESF system is preferred in all instances. Each system has its unique strengths and weaknesses. Both systems add significantly to the spectrum of fractures that can be effectively treated as compared to coaptation or intramedullary pin + cerclage wire techniques. The bone plate and screw system has the advantage of simplifying postoperative care, while the ESF system provides versatility and the opportunity to maximize the biologic potential for healing within the fracture zone. Biologic application of bone plates or internal fixators has been developed to overcome some of the biologic disadvantages of conventional bone plating. […]