fixateur

Fixateur is an externally applied orthopedic fixation device used to immobilize and align bone fragments during healing. The system comprises percutaneous pins or wires inserted into bone on either side of the injury and an external frame of rods, clamps, and rings that holds the fragments in the desired position. By adjusting the frame, clinicians can stabilize fractures, maintain alignment after surgical reduction, correct deformities, or lengthen bone segments.

Indications include complex or open fractures, comminuted injuries, bone loss, deformity correction, and limb-length discrepancies where internal fixation is unsafe or impractical. Designs vary: unilateral external fixators, circular fixators (ring-type systems), and hybrid configurations that combine elements. Common materials are stainless steel and titanium; components include pins and wires, connectors, rods, clamps, and, in circular systems, rings.

Procedure typically involves anesthesia, insertion of pins or wires through skin into bone, assembly of the external frame around the limb, imaging verification, and postoperative care. Adjustments are performed to achieve proper alignment or gradual lengthening, often over weeks to months. Pin-site care and infection risk are important considerations.

Advantages include minimal soft-tissue dissection, adjustability during treatment, and the ability to restore anatomy or permit early joint movement. Limitations include pin-site infections, frame loosening, patient discomfort, and the need for meticulous care and follow-up. Complications can include neurovascular injury, stiffness, or nonunion if healing is impaired.

History: Modern external fixation evolved in the 20th century with contributions from several surgeons; circular fixators popularized by the Ilizarov method advanced deformity correction and limb lengthening.

See also external fixator, Ilizarov apparatus, limb lengthening.