How to Care for an External Fixator

An external fixator is a device that holds a broken bone in a stable (fixed) position until it heals. This device is often used on the arms, legs, pelvis, or neck.

It is attached to the bones with screws that are called pins or bolts. The pins are drilled into the bone on each side of the break and are attached to a metal or carbon fiber rod with nuts. When the bone is fully healed, the external fixator is removed.

The type of external fixator that you have will depend on which bone is broken. Most people need an external fixator for 6–12 weeks. Sometimes, it is needed for up to 1 year for fractures that heal slowly or fractures that require slow alteration in alignment.

What are the risks?

Generally, external fixators are safe to wear. However, problems may occur, including infection at the pin sites.

How to care for your external fixator

Different types of external fixators will have different instructions for care. Your health care provider will tell you how to care for the type that you have. In general, you should:

• Examine your external fixator every day.
  • Check for any loose pins. One sign of looseness is pain at the site where the pin exits the skin or pain at the site of the break.
  • Make sure the nuts are tight. Your health care provider may show you how to tighten the nuts. However, do not make any adjustments to your external fixator unless told to do so by your health care provider.
• Check the pin sites every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

How to clean the pin sites

Clean the pin sites two times a day or as often as told by your health care provider. Pin sites are the spots where the pins go through your skin. There are various types of pin-cleaning solutions. Use the solution that is recommended by your health care provider. One option is a mixture of hydrogen peroxide and saline solution.

Supplies Needed

• Hydrogen peroxide.
• Saline solution.
• Sterile cotton swabs.
• Sterile gauze.

Cleaning the Pin Sites

1. Wash your hands with soap and water.
2. In a sterile container, make a cleaning solution by mixing equal amounts of hydrogen peroxide and saline solution.
3. Dip a cotton swab in the mixture. Swab around the base of the pin, where it meets your skin. Use a circular motion. If your skin has moved up onto the pin, gently push it back down. Remove any crusts that have formed on the pin. After you have swabbed the base of the pin, clean the rest of the pin.
4. Use a new swab for each pin.
5. Dry each pin site with a clean cotton swab.

How to care for the frame

Clean the frame of the fixator two times a week or as often as told by your health care provider. Use a 4×4 inch (10×10 cm) gauze square that is moistened with rubbing alcohol and water. After you clean the frame, wipe it dry with a towel. Use a new gauze square and a clean towel for each cleaning. When your health care provider says that you can take showers, you can clean the frame in the shower.

Contact a health care provider if:

• You have more redness, swelling, or pain at any pin site.
• You have more fluid or blood coming from a pin site.
• A pin site feels warm to the touch.
• You have pus or a bad smell coming from a pin site.
• You have a fever.

Get help right away if:

• A pin moves or becomes loose.
• You have increasing pain where your bone was broken.