Orthopedic Carbon Fiber External Fixators Surgical Techniques

Surgical Technique for Orthopedic Carbon Full Rings (Adult) Ilizarov External Fixator

The Ilizarov external fixator is a versatile system used for limb reconstruction, deformity correction, and fracture management. This detailed surgical technique focuses on the application of full carbon rings in adult patients.

Preoperative Planning

1. Clinical Evaluation: Thorough history and physical examination, including assessment of neurovascular status, soft tissue condition, and skeletal alignment.

2. Radiographic Imaging: Full-length X-rays and/or CT scans to evaluate bone quality, deformity, and fracture configuration.

3. Frame Design: Meticulous planning of ring size, number, and placement, wire/pin configuration, and anticipated adjustments.

Surgical Procedure

1. Patient Positioning: Supine or lateral position depending on the surgical site. Adequate padding and support to maintain proper alignment.

2. Anesthesia: General or regional anesthesia based on patient factors and surgical complexity.

3. Skin Incision and Dissection: Minimal incisions for wire/pin insertion, avoiding neurovascular structures and tendons.

4. Ring Placement:

   • Proximal and distal rings applied first, aligned with anatomical landmarks.

   • Intermediate rings added as needed for stability and deformity correction.

   • Rings secured with threaded rods, ensuring adequate soft tissue clearance.

5. Wire/Pin Insertion:

   • K-wires or half-pins inserted percutaneously, avoiding "safe zones" to minimize neurovascular injury.

   • Wires tensioned and secured to rings with wire fixation bolts.

   • Number and configuration of wires/pins determined by stability requirements.

6. Corticotomy/Osteotomy: If indicated, performed after frame application to minimize soft tissue disruption.

7. Wound Closure: Minimal closure of skin incisions. Sterile dressings applied.

Postoperative Management

1. Neurovascular Monitoring: Regular assessment of distal circulation and nerve function.

2. Pin Site Care: Daily cleaning with antiseptic solution to prevent infection.

3. Frame Adjustments: Gradual adjustments as needed for deformity correction or limb lengthening.

4. Weight-Bearing: As tolerated based on fracture stability and bone healing.

5. Physical Therapy: Early mobilization and rehabilitation to maintain joint function and muscle strength.

Key Considerations

• Carbon Rings: Lightweight and radiolucent, allowing for improved patient comfort and imaging assessment.

• Safe Zones: Anatomical regions with minimal neurovascular structures, identified for safe wire/pin placement.

• Wire/Pin Tension: Adequate tension is crucial for stability but excessive tension can lead to complications.

• Pin Site Infection: A common complication, managed with meticulous pin site care and antibiotics if necessary.

• Patient Education: Comprehensive instructions on frame care, weight-bearing, and potential complications.

Disclaimer: This surgical technique provides a general overview. Specific procedures may vary depending on patient factors, fracture complexity, and surgeon preference. Consult with a qualified orthopedic surgeon for personalized treatment planning and management

The following is a detailed surgical technique for the application of Orthopedic Carbon 3/4 Rings (Adult) Ilizarov External Fixator. This information is for educational purposes only and should not be used as a substitute for professional medical advice. Always consult with a qualified healthcare provider  before making any decisions  about your health or treatment.  

Preoperative Planning

1. Patient Evaluation: Thoroughly assess the patient's medical history, including any allergies, previous surgeries, and current medications.

2. Imaging Studies: Obtain appropriate radiographic images (X-rays, CT scans, MRI) to evaluate the fracture or deformity and plan the fixator construct.

3. Frame Design: Determine the appropriate ring size, number of rings, and configuration based on the patient's anatomy and the specific indication.

4. Equipment and Instruments: Ensure all necessary equipment and instruments are available, including carbon fiber rings, connecting rods, Kirschner wires (K-wires), Schanz screws, drill bits, drivers, and wrenches.

Surgical Technique

1. Patient Positioning: Position the patient appropriately on the operating table, ensuring adequate access to the surgical site.

2. Anesthesia: Administer general or regional anesthesia, depending on the patient's condition and the complexity of the procedure.

3. Skin Preparation and Draping: Prepare the surgical site with antiseptic solution and drape the area to maintain a sterile field.

4. Ring Placement:

   • Place the rings around the affected limb, ensuring adequate soft tissue clearance and alignment with the bone.

   • Secure the rings temporarily with clamps or Kirschner wires.

5. Wire/Screw Insertion:

   • Insert Kirschner wires or Schanz screws through the bone and rings, using safe zones to avoid neurovascular structures.

   • Ensure proper wire/screw tension to achieve stable fixation.

6. Rod Placement:

   • Connect the rings with threaded rods, ensuring proper alignment and stability.

   • Tighten the rods to achieve the desired compression or distraction.

7. Corticotomy (if necessary):

   • If performing a bone lengthening or deformity correction, perform a corticotomy (controlled break in the bone cortex).

   • Protect neurovascular structures during the corticotomy.

8. Wound Closure:

   • Close the surgical incisions with appropriate sutures or staples.

   • Apply sterile dressings to the pin/wire insertion sites.

Postoperative Care

1. Neurovascular Monitoring: Regularly assess neurovascular status of the affected limb.

2. Pin/Wire Site Care: Clean the pin/wire insertion sites daily with antiseptic solution and apply sterile dressings.

3. Pain Management: Provide adequate pain relief as needed.

4. Weight-bearing and Mobilization: Follow the surgeon's instructions regarding weight-bearing and mobilization.

5. Follow-up: Schedule regular follow-up appointments to monitor healing and adjust the fixator as needed.

Additional Considerations

• Carbon Fiber Rings: Carbon fiber rings offer several advantages over traditional metal rings, including lighter weight, improved radiolucency, and potential for better patient comfort.

• Hybrid Constructs: In some cases, a combination of carbon fiber and metal rings may be used to optimize frame stability and stiffness.

• Infection Prevention: Strict adherence to sterile technique is crucial to prevent pin/wire tract infections.

• Patient Education: Provide thorough patient education regarding pin/wire site care, weight-bearing restrictions, and potential complications.

Remember: This is a general overview of the surgical technique. The specific steps and details may vary depending on the patient's individual needs and the surgeon's preferences. Always consult with a qualified healthcare provider for personalized advice and treatment.

Surgical Technique for Orthopedic Carbon 5/8 Rings (Adult) External Fixator

Introduction

The Carbon 5/8 Rings External Fixator system is used for stabilizing fractures, correcting deformities, and performing limb lengthening. It offers lightweight, durable, and biocompatible properties, making it ideal for adult orthopedic applications.

Preoperative Preparation

1. Patient Evaluation:

   • Conduct a thorough clinical and radiological assessment of the affected limb.

   • Determine the exact deformity or fracture alignment and plan fixation points.

2. Surgical Planning:

   • Create a preoperative template using imaging studies.

   • Select appropriate ring sizes and additional components like connecting rods and wires.

3. Sterilization:

   • Ensure all components, including carbon rings and accessories, are sterilized per the manufacturer’s guidelines (e.g., autoclave or EO sterilization).

4. Anesthesia:

   • General or regional anesthesia is administered based on the patient’s condition.

Surgical Procedure

Step 1: Positioning

• Place the patient supine or as required by the fracture’s location.

• Use a radiolucent table to facilitate intraoperative imaging.

Step 2: Incision and Exposure

• Make minimal incisions to access the bony landmarks where wires and pins will be inserted.

• Preserve soft tissues to reduce the risk of postoperative infection.

Step 3: Wire Insertion

• Transosseous Wires:

  • Drill transosseous wires at the planned entry points using a power drill.

  • Ensure bicortical purchase while avoiding neurovascular structures.

  • Insert tensioned wires at approximately 130–150 N to achieve stability.

• Olive Wires (if required):

  • Insert olive wires to correct angulation or translation deformities.

  • Secure wires using appropriate clamps on the carbon rings.

Step 4: Fixator Assembly

• Ring Positioning:

  • Attach the Carbon 5/8 Rings around the limb, maintaining even spacing.

  • Ensure proper alignment with the axis of the bone.

• Connecting Components:

  • Use carbon rods or adjustable hinges to connect the rings.

  • Tighten all nuts and bolts while maintaining the desired alignment.

Step 5: Fine-Tuning

• Verify the alignment using fluoroscopy or X-rays.

• Adjust the frame to achieve optimal reduction and limb alignment.

• Tighten all fasteners and recheck wire tension.

Postoperative Management

1. Radiographic Evaluation:

   • Perform immediate postoperative X-rays to confirm proper fixation and alignment.

2. Soft Tissue Care:

   • Apply sterile dressings around pin sites.

   • Educate the patient on pin site care to prevent infections.

3. Rehabilitation:

   • Initiate range-of-motion exercises and weight-bearing as tolerated.

   • Gradually increase activity levels under physician guidance.

4. Follow-Up:

   • Schedule regular follow-ups to monitor bone healing and frame stability.

   • Perform adjustments to the fixator as needed.

Key Considerations

1. Avoid Complications:

   • Ensure meticulous planning and intraoperative technique to avoid pin-site infections, neurovascular damage, or nonunion.

2. Material-Specific Benefits:

   • Leverage the lightweight and radiolucent properties of carbon rings for enhanced patient comfort and ease of imaging.

3. Component Compatibility:

   • Ensure all components used are compatible with the Carbon 5/8 Rings system.

4. Postoperative Monitoring:

   • Closely monitor for signs of infection, wire loosening, or mechanical failure.

Conclusion

The Carbon 5/8 Rings External Fixator system offers a versatile solution for adult orthopedic procedures requiring external fixation. Adherence to proper surgical technique and postoperative management is critical for successful outcomes and patient satisfaction.

Surgical Technique for Orthopedic Carbon Half Rings (Adult) External Fixator

Preoperative Planning

1. Patient Evaluation:

   • Assess the type and severity of the injury or deformity requiring fixation.

   • Perform imaging studies (X-rays, CT scans) to map the fracture or deformity.

2. Equipment Preparation:

   • Ensure the availability of carbon half rings of appropriate sizes.

   • Prepare the external fixator system, including connecting rods, threaded pins, and clamps.

   • Confirm sterilization of all instruments and implants.

3. Sterile Field Setup:

   • Establish a sterile operating field with all necessary equipment accessible.

   • Position the patient as required for optimal access to the surgical site.

Surgical Procedure

1. Anesthesia and Positioning:

   • Administer general or regional anesthesia as per the patient’s condition.

   • Position the patient on the operating table, ensuring proper exposure of the affected limb.

2. Skin Preparation and Draping:

   • Perform an antiseptic scrub of the surgical area.

   • Drape the limb to maintain sterility.

3. Pin Placement:

   • Identify appropriate entry points for the pins based on the fracture or deformity location.

   • Make small incisions at the planned pin sites to minimize tissue damage.

   • Drill pilot holes using a power drill with a suitable guide to ensure accurate placement.

   • Insert threaded pins into the bone cortex, ensuring bicortical purchase for stability.

4. Ring Application:

   • Align the carbon half rings with the pin entry points.

   • Attach the rings to the threaded pins using appropriate clamps and bolts.

   • Ensure that the rings are properly oriented and adjusted for anatomical alignment.

5. Connecting the Rings:

   • Attach connecting rods between the rings to create a stable frame.

   • Adjust the rods to achieve the desired alignment and tension.

6. Stability Check:

   • Confirm the stability of the frame by applying manual stress to ensure no movement at the fracture or deformity site.

   • Tighten all bolts and clamps securely.

Postoperative Management

1. Wound Care:

   • Cover pin sites with sterile dressings.

   • Educate the patient on pin site care to prevent infection.

2. Imaging Verification:

   • Obtain postoperative imaging to confirm proper alignment and fixation.

3. Rehabilitation:

   • Initiate physical therapy as recommended to promote mobility and prevent stiffness.

   • Gradually adjust the fixator components during follow-up to optimize healing.

4. Complication Monitoring:

   • Monitor for signs of infection, neurovascular compromise, or mechanical failure of the fixator.

Follow-Up

• Schedule regular follow-up visits for clinical and radiological assessment.

• Plan for fixator removal once the fracture or deformity has adequately healed, typically under anesthesia in a sterile environment.

Notes

• Always adhere to the manufacturer’s guidelines for the specific external fixator system.

• Tailor the surgical approach and postoperative care to the individual patient’s needs and medical condition.

Surgical Technique for Orthopedic Carbon Half Rings (Pediatric) External Fixator

1. Preoperative Planning

• Patient Evaluation: Assess the fracture or deformity using clinical and radiological evaluations (X-rays, CT, or MRI as needed).

• Device Selection: Choose the appropriate size and configuration of carbon half rings based on the patient’s anatomy and pathology.

• Instrumentation Preparation: Verify the availability of all required tools, including carbon half rings, connecting rods, clamps, wires, screws, and a power drill.

2. Patient Positioning

• Position the patient under general or regional anesthesia.

• Ensure the limb is accessible and properly supported, using a radiolucent table for fluoroscopic guidance.

3. Surgical Approach

• Incision Planning: Identify the anatomical landmarks and mark entry points for wires or pins.

• Skin Preparation: Cleanse and drape the surgical site in a sterile manner.

4. Fixator Assembly

• Frame Pre-Assembly: Assemble the carbon half rings and connecting rods outside the surgical field. Adjust to match the estimated dimensions of the patient’s limb.

• Wire Insertion:

  • Select the appropriate diameter and length of the Kirschner wires (K-wires).

  • Insert wires perpendicularly to the bone, avoiding neurovascular structures. Use fluoroscopy to ensure accurate placement.

  • Tension the wires to the manufacturer’s recommended specifications.

• Half-Ring Attachment:

  • Secure the wires to the carbon half rings using clamps.

  • Ensure that the tension is evenly distributed to maintain stability.

5. Frame Adjustment

• Align the fixator to achieve the desired anatomical position, using fluoroscopy for guidance.

• Adjust the connecting rods and clamps to achieve optimal fixation without compromising soft tissue.

6. Additional Stabilization

• If needed, insert Schanz screws or additional wires for enhanced stability.

• Ensure that all connections are tightened securely to prevent frame loosening.

7. Postoperative Evaluation

• Verify the frame’s alignment and stability using fluoroscopic or radiographic imaging.

• Confirm that the limb’s circulation and neurological status are intact.

8. Wound Closure

• Close any surgical incisions with sutures or staples.

• Dress the pin or wire insertion sites with sterile dressings.

9. Postoperative Care

• Immediate Care:

  • Monitor the patient for signs of neurovascular compromise or infection.

  • Provide analgesics and antibiotics as indicated.

• Physical Therapy:

  • Initiate a rehabilitation program to maintain joint mobility and muscle strength.

• Follow-Up:

  • Regularly assess the fixation frame for stability and alignment.

  • Adjust the fixator configuration as needed for fracture healing or deformity correction.

10. Device Removal

• Once healing is confirmed radiologically, remove the fixator in a sterile setting under anesthesia.

• Address any residual pin or wire tract infections if present.

Precautions

• Avoid placing wires or screws near growth plates to prevent iatrogenic damage.

• Regularly inspect the fixator for signs of loosening or mechanical failure.

• Educate the patient and caregivers about pin site care to minimize infection risks.

References

• Manufacturer’s surgical guidelines for the specific external fixator system.

• Latest orthopedic and pediatric surgical standards for external fixation techniques.

Disclaimer This surgical technique should be performed by qualified orthopedic surgeons with expertise in pediatric external fixation procedures. Always refer to the specific product’s instructions for use.

Surgical Technique for Orthopedic Carbon 5/8 Rings (Pediatric) External Fixator

1. Preoperative Planning:

• Conduct a thorough clinical assessment and imaging studies (X-ray, CT, or MRI) to evaluate the deformity, fracture, or defect.

• Determine the appropriate size and configuration of the 5/8 carbon rings based on the patient’s anatomy and surgical requirements.

• Prepare templates to pre-plan pin/wire placement and ring alignment.

2. Patient Preparation:

• Place the patient in a supine or prone position, depending on the surgical site.

• Administer general or regional anesthesia as per patient-specific factors.

• Ensure proper aseptic techniques and draping of the surgical site.

3. Frame Assembly (Preliminary):

• Assemble the external fixator frame on a sterile table.

• Use the modular design to configure the carbon 5/8 rings and connecting rods. Adjustments can be made intraoperatively.

4. Wire and Pin Insertion:

• Identify safe corridors for wire and pin insertion to avoid neurovascular structures.

• Make a small incision at the planned pin/wire site and bluntly dissect to bone.

• Insert smooth or olive wires perpendicularly or at the desired angle through the bone using a power drill under fluoroscopic guidance.

• Tension the wires to the manufacturer’s recommended specifications using a wire tensioner to enhance frame stability.

• For half-pins, use threaded pins with bicortical purchase, ensuring proper alignment and avoiding excessive heat generation during drilling.

5. Frame Application:

• Attach the pre-assembled carbon 5/8 rings to the tensioned wires and pins.

• Secure the rings using connecting rods and clamps, ensuring the frame aligns with the anatomical axis of the limb.

• Adjust the frame to accommodate planned corrections, such as angular deformities or limb length discrepancies.

6. Deformity Correction and Stabilization:

• If correcting deformities, utilize hinges, sliders, or telescopic rods to apply gradual adjustments postoperatively.

• Confirm alignment and stability intraoperatively using fluoroscopy.

• Tighten all clamps and bolts securely to maintain the desired configuration.

7. Postoperative Radiographic Verification:

• Obtain immediate postoperative X-rays to confirm proper alignment, stability, and fixation.

• Ensure that no wires or pins are causing undue stress or are improperly positioned.

8. Wound Closure and Dressing:

• Irrigate all pin and wire insertion sites with sterile saline.

• Apply antiseptic dressings around each pin and wire site.

• Close any surgical wounds with sutures or staples as needed.

9. Postoperative Care:

• Educate the patient and caregivers on pin site care to prevent infection.

• Schedule regular follow-ups for frame adjustments, if necessary, and monitor healing progress through clinical and radiographic evaluations.

• Encourage gradual weight-bearing as tolerated, based on the stability of the construct and the surgeon’s discretion.

10. Frame Removal:

• Once healing is confirmed radiographically and clinically, schedule frame removal under sterile conditions.

• Remove wires and pins carefully to avoid soft tissue damage.

• Apply a compression bandage to the surgical site and monitor for any complications.

Important Considerations:

• Use carbon rings for their lightweight, radiolucent properties, which facilitate imaging and reduce patient discomfort.

• Pay close attention to the unique anatomical features and growth considerations of pediatric patients.

• Maintain meticulous aseptic techniques throughout the procedure to minimize infection risk.

References:

• Manufacturer’s guidelines for Orthopedic Carbon 5/8 Rings.

• Latest clinical protocols and standards for pediatric external fixation.

Detailed Surgical Technique for Orthopedic Carbon 3/4 Ring (Pediatric) External Fixator

Preoperative Planning

1. Patient Evaluation:

   • Obtain a thorough patient history and physical examination.

   • Evaluate the deformity or fracture using X-rays, CT scans, or MRI as required.

   • Determine the size and type of the external fixator components based on patient age, size, and pathology.

2. Instrumentation and Implants Required:

   • Carbon 3/4 ring components.

   • Transfixion wires and half-pins.

   • Connection rods, clamps, and nuts.

   • Drill and drill bits.

   • Torque wrench.

   • Sterile drapes, antiseptics, and standard surgical instruments.

3. Surgical Site Preparation:

   • Mark the incision sites based on the anatomical landmarks.

   • Confirm the planned pin and wire insertion points under fluoroscopy.

Operative Steps

1. Patient Positioning:

• Position the patient under general or regional anesthesia.

• Ensure the limb is accessible and stabilized using a padded support.

2. Incision and Wire Insertion:

• Make small stab incisions at the predetermined wire entry and exit points.

• Insert a transfixion wire through the bone using a power drill or hand drill.

• Ensure that the wire is parallel to the joint line and perpendicular to the bone axis to avoid soft tissue damage.

• Repeat for additional wires as needed, ensuring proper spacing for stability.

3. Fixator Ring Assembly:

• Attach the 3/4 carbon ring to the wires using wire tensioners and clamps.

• Confirm the ring's alignment and adjust if necessary to maintain the correct anatomical position.

4. Pin Placement:

• Place half-pins perpendicularly to the bone at the predetermined locations.

• Use a guide to ensure accurate drilling and avoid neurovascular structures.

• Secure the pins to the carbon ring using clamps.

5. Frame Construction:

• Connect the carbon rings with rods and hinges based on the deformity correction or stabilization requirements.

• Tighten all connections using a torque wrench, avoiding overtightening.

6. Intraoperative Verification:

• Verify the alignment of the bone and fixator frame using fluoroscopy.

• Adjust the frame as needed to correct deformity or ensure proper stabilization of the fracture.

Postoperative Care

1. Dressing and Sterility:

   • Apply sterile dressings around the pin and wire insertion sites.

   • Ensure proper coverage to prevent infection.

2. Patient Mobilization:

   • Encourage early mobilization as tolerated, depending on the injury and fixation stability.

   • Provide weight-bearing instructions as per the surgeon’s protocol.

3. Follow-Up and Adjustments:

   • Schedule regular follow-ups for frame adjustments, monitoring healing, and pin site care.

   • Use fluoroscopic or radiographic evaluation to assess bone healing.

4. Pin Site Care:

   • Educate the patient and caregiver on daily pin site cleaning.

   • Use antiseptic solutions to prevent infection.

Complications to Monitor

• Infection at pin and wire sites.

• Loosening or breakage of components.

• Neurovascular injury during pin or wire placement.

• Delayed union or non-union of the fracture.

Conclusion

The Carbon 3/4 Ring External Fixator is a versatile and effective tool for managing pediatric fractures and deformities. Proper preoperative planning, meticulous surgical technique, and diligent postoperative care are essential to achieve optimal outcomes.

Surgical Technique for Orthopedic Carbon 3/8 Ring (Adult) External Fixator

1. Preoperative Planning

• Patient Evaluation: Assess fracture type, deformity, and soft tissue condition. Perform preoperative imaging (X-rays, CT scans) to evaluate bone alignment and plan fixation points.

• Device Preparation: Ensure all components of the Carbon 3/8 Ring system are available, sterile, and checked for compatibility.

2. Anesthesia and Positioning

• Anesthesia: General or regional anesthesia based on patient and surgeon preference.

• Positioning: Place the patient on a radiolucent table, ensuring optimal access to the surgical site.

3. Skin Preparation and Incision

• Perform a thorough antiseptic preparation of the affected limb.

• Make small stab incisions over the planned pin or wire insertion points to reduce soft tissue damage.

4. Pin/Wire Placement

• Insert transosseous wires or half-pins perpendicularly to the long axis of the bone at the pre-planned sites. Use image guidance to ensure correct positioning.

• Avoid crossing neurovascular structures or joints during pin placement.

5. Frame Assembly

• Lower Ring: Secure the first Carbon 3/8 Ring to the distal set of pins/wires using wire tensioners or clamps. Ensure alignment with the fracture.

• Upper Ring: Attach the second Carbon 3/8 Ring proximally. Connect the rings using threaded rods or telescopic struts.

• Adjustments: Align the rings parallel to each other and perpendicular to the limb axis. Confirm fracture reduction using intraoperative imaging.

6. Fracture Reduction

• Perform closed or open reduction of the fracture.

• Adjust the frame components to achieve the desired alignment and compression across the fracture site.

7. Dynamic Stabilization (If Needed)

• Incorporate hinges or distractors to allow controlled joint movement or lengthening, as required.

8. Final Tightening and Stability Check

• Tighten all clamps and connectors to secure the frame.

• Test the stability of the construct and confirm adequate fixation using imaging.

9. Soft Tissue Management

• Irrigate pin/wire sites with saline.

• Close incisions around pins with interrupted sutures, if necessary.

10. Postoperative Care

• Pin/Wire Care: Educate the patient on cleaning and monitoring for signs of infection.

• Weight Bearing: Initiate weight-bearing based on the fracture type and surgeon’s preference.

• Follow-up: Schedule regular follow-up visits to monitor bone healing and adjust the frame as needed.

11. Frame Removal

• Once radiological evidence of healing is confirmed, remove the frame under sterile conditions.

Here’s a detailed surgical technique for the application of the Orthopedic Carbon 1/4 Rings (Adult) External Fixator:

Introduction

The Orthopedic Carbon 1/4 Ring External Fixator is used for stabilizing fractures, deformity corrections, or limb-lengthening procedures. Carbon material provides lightweight strength and radiolucency, enhancing intraoperative imaging.

Preoperative Planning

1. Patient Assessment:

   • Review patient history, X-rays, and CT scans.

   • Determine the size and number of 1/4 rings required based on the anatomy.

2. Preparation of Equipment:

   • Carbon 1/4 rings (adult size).

   • Schanz screws or Kirschner wires (K-wires).

   • Connecting rods, bolts, and hinges.

   • Drill, guide wires, and pin clamps.

   • Sterile field setup for all instruments.

3. Marking and Positioning:

   • Position the patient based on the fracture or deformity location (supine, prone, or lateral).

   • Use a tourniquet if required, ensuring the limb is accessible and stable.

Surgical Technique

Step 1: Incision and Exposure

• Make small, minimally invasive incisions for pin or wire insertion.

• Avoid vital neurovascular structures by referring to preoperative imaging.

Step 2: Pin or Wire Insertion

1. Schanz Screws:

   • Insert Schanz screws perpendicularly to the bone at pre-marked locations.

   • Use fluoroscopic guidance to ensure proper trajectory and depth.

   • Attach the screw clamps to secure the screws to the frame.

2. K-Wires:

   • Drill K-wires transversely through the bone.

   • Maintain a bicortical purchase for stability.

   • Tension the wires using a wire tensioner to enhance frame rigidity.

Step 3: Assembly of the 1/4 Rings

• Place the carbon 1/4 rings around the limb, ensuring a snug fit without compression.

• Attach the rings to the pins or wires using bolts and clamps.

• Connect the rings with carbon rods or hinges to create a stable external frame.

Step 4: Frame Alignment

• Adjust the frame for:

  • Limb length restoration.

  • Correction of angular or rotational deformities.

  • Gradual compression or distraction as needed.

• Tighten all bolts to secure the assembly.

Step 5: Fluoroscopic Confirmation

• Verify the alignment and positioning under fluoroscopy.

• Ensure the frame does not impinge on soft tissues or restrict joint movement.

Postoperative Care

1. Wound Management:

   • Dress pin or wire sites with sterile dressings.

   • Monitor for infection or inflammation.

2. Rehabilitation:

   • Begin early mobilization as tolerated.

   • Educate the patient on weight-bearing limitations and frame care.

3. Follow-Up:

   • Schedule regular radiographic evaluations to monitor healing.

   • Adjust the frame for progressive correction if part of the treatment goal.

4. Frame Removal:

   • Once healing is confirmed, remove the frame under local or general anesthesia.

Surgical Technique for Orthopedic Carbon Italian Arch 90-Degree External Fixator

1. Introduction

The Orthopedic Carbon Italian Arch 90-Degree External Fixator is designed for the treatment of fractures, deformity corrections, and limb lengthening. This system provides a stable, lightweight, and radiolucent frame for precise anatomical alignment.

2. Preoperative Planning

• Conduct a thorough clinical and radiographic evaluation to determine fracture location, type, and alignment needs.

• Ensure the required components, including the Italian Arch 90-degree ring, fixation pins, connecting rods, and clamps, are available.

• Sterilize all instruments and implants according to standard procedures.

• Obtain patient consent and perform necessary anesthesia assessments.

3. Patient Positioning

• Position the patient supine on a radiolucent operating table.

• For lower limb fractures, apply a tourniquet if needed.

• Drape the surgical area while ensuring the anatomical landmarks remain accessible.

4. Surgical Approach

A. Pin Insertion

1. Identify and mark the pin insertion sites using fluoroscopic guidance.

2. Make small stab incisions at each pin entry point.

3. Insert self-drilling, self-tapping Schanz pins (typically 5-6mm diameter for adults) into the bone using a power drill, ensuring bicortical purchase.

4. Maintain parallel pin placement to optimize stability and minimize stress concentration.

B. Frame Assembly and Fixation

1. Attach the Italian Arch 90-degree ring to the fixation pins using rod-to-ring clamps.

2. Secure the ring with appropriate connecting rods to adjacent fixation components.

3. Ensure proper alignment and stability of the external fixator.

4. Tighten all clamps and check for any instability.

C. Adjustments and Fine-Tuning

1. Verify the alignment with fluoroscopy and adjust as needed.

2. Confirm joint mobility and soft tissue clearance.

3. If deformity correction or distraction is required, incorporate an adjustable strut mechanism.

4. Ensure all connections are secure to prevent post-operative displacement.

5. Postoperative Management

• Wound Care: Monitor pin sites for signs of infection and apply antiseptic dressings.

• Weight-Bearing Instructions: Partial or full weight-bearing as per fracture stability and surgeon’s discretion.

• Follow-up Imaging: Regular X-rays to assess healing and alignment.

• Rehabilitation: Gradual mobilization with physiotherapy for joint function restoration.

• Frame Removal: Once healing is confirmed radiographically, the fixator is removed under local or general anesthesia.

6. Complications and Management

• Pin tract infection: Treated with local wound care and antibiotics.

• Frame instability: Reassess and tighten loose components.

• Delayed union or malunion: Consider dynamization or bone grafting if needed.

7. Conclusion

The Orthopedic Carbon Italian Arch 90-Degree External Fixator provides a versatile and effective solution for complex fractures and limb reconstructions. Proper application, close monitoring, and patient compliance are critical for successful outcomes.

Surgical Technique for Orthopedic Carbon Italian Arch 120° External Fixator

1. Introduction The Orthopedic Carbon Italian Arch 120° External Fixator is designed for stabilizing complex fractures, bone deformities, and limb lengthening procedures. This fixator provides a lightweight yet strong construct, ensuring optimal patient outcomes with minimal interference to soft tissues.

2. Preoperative Planning

• Perform a thorough clinical and radiological assessment of the fracture or deformity.

• Select appropriate fixator components, including rings, connecting rods, Schanz screws, and additional hardware.

• Ensure proper sterilization of all instruments and implants.

• Position the patient based on the surgical site (supine or lateral decubitus).

3. Anesthesia and Patient Positioning

• Administer general or regional anesthesia as per the patient’s medical condition.

• Position the limb on a radiolucent table to facilitate intraoperative fluoroscopy.

• Apply antiseptic preparation and draping to maintain a sterile field.

4. Pin Insertion and Frame Assembly

• Identify safe zones for pin placement to avoid neurovascular structures.

• Under fluoroscopic guidance, insert self-drilling, self-tapping Schanz screws at the predetermined sites.

• Secure each pin to a carbon fiber ring, ensuring optimal alignment.

• Connect the Italian Arch 120° component to the primary fixation system using rods and clamps.

• Adjust the frame alignment to ensure proper reduction of the fracture or deformity.

5. Final Fixation and Stability Check

• Tighten all screws and clamps to ensure rigid fixation.

• Use fluoroscopy to confirm fracture reduction and alignment.

• Perform dynamic testing by moving the limb gently to assess the construct's stability.

6. Postoperative Management

• Apply sterile dressings around pin sites to minimize infection risk.

• Advise partial or non-weight-bearing based on fracture type and stability.

• Schedule regular follow-ups for radiographic monitoring and frame adjustments.

• Educate the patient on pin site care and frame maintenance to prevent complications.

7. Frame Removal

• Once bone healing is confirmed via radiographs, plan fixator removal.

• Loosen clamps and carefully extract pins under local or regional anesthesia.

• Apply a supportive cast or brace if needed for gradual transition to full weight-bearing.

8. Potential Complications and Management

• Pin tract infection: Manage with local wound care and oral antibiotics.

• Malalignment: Adjust frame components under fluoroscopic guidance.

• Neurovascular injury: Ensure proper pin placement and immediate assessment if symptoms arise.

9. Conclusion The Orthopedic Carbon Italian Arch 120° External Fixator provides a versatile and effective solution for complex orthopedic conditions. Proper surgical technique and postoperative care are critical for achieving successful patient outcomes.

References

• Latest international orthopedic fixation guidelines.

• Manufacturer’s surgical protocol and recommendations.

• Clinical case studies and peer-reviewed literature on external fixation techniques.

Surgical Technique for Orthopedic Carbon Connecting Plates (Short Adult) External Fixator

1. Introduction:
The orthopedic carbon connecting plates (short adult) external fixator is a modular system designed for external stabilization of fractures, deformities, or limb lengthening procedures. The carbon material ensures lightweight strength and radiolucency, aiding in intraoperative imaging.

2. Preoperative Planning:

• Evaluate patient history and imaging to determine fracture characteristics.

• Select appropriate frame components, including the carbon connecting plates, Schanz pins, and clamps.

• Ensure all instruments and implants are sterile and prepared.

• Position the patient accordingly, typically in supine or lateral positioning, depending on the affected limb.

3. Surgical Procedure:

A. Incision and Pin Insertion:

• Make small stab incisions at the planned pin insertion sites.

• Utilize a drill guide to insert Schanz pins percutaneously into the bone, ensuring bicortical purchase.

• Maintain parallel pin placement to optimize frame stability and biomechanical performance.

• Confirm correct pin positioning using fluoroscopy.

B. Assembly of External Fixator Frame:

• Attach the Schanz pins to the carbon connecting plates using the multi-hole clamps.

• Adjust the frame to align with the anatomical reduction of the fracture.

• Ensure proper spacing between pins to distribute forces evenly.

C. Fracture Reduction and Fixation:

• Perform manual or assisted reduction of the fracture.

• Lock the clamps onto the carbon connecting plates to maintain fracture alignment.

• Verify reduction under fluoroscopy.

D. Final Tightening and Stability Check:

• Tighten all clamps and connections securely.

• Confirm the construct’s rigidity by applying mild stress to the fixator.

• Reassess alignment and stability using intraoperative imaging.

4. Postoperative Care:

• Apply sterile dressings to pin sites and educate the patient on pin care.

• Initiate early mobilization as per surgeon's discretion.

• Schedule regular follow-ups with radiographic evaluations to monitor healing progress.

• Adjust or remove fixator components when clinically appropriate.

5. Complications and Management:

• Pin tract infection: Managed with local wound care and antibiotics.

• Frame instability: Requires retightening or additional pin insertion.

• Delayed union or malunion: May require revision fixation or bone grafting.

6. Conclusion:
The use of orthopedic carbon connecting plates in external fixation provides a reliable, adjustable, and radiolucent stabilization method. Proper technique and post-surgical care enhance patient outcomes and promote optimal bone healing.

Surgical Technique for Orthopedic Carbon Connecting Plates (Short Pediatric) External Fixator

1. Preoperative Planning:

• Perform a thorough clinical and radiological assessment of the fracture.

• Assess limb alignment and soft tissue condition.

• Select appropriate carbon connecting plates and external fixator components based on patient anatomy.

• Ensure sterile field preparation and appropriate anesthesia (regional or general) as required.

2. Patient Positioning:

• Place the patient in a supine or lateral position on a radiolucent operating table.

• Ensure proper padding to avoid pressure sores.

• Position the limb in a way that provides optimal access to the fracture site.

3. Skin Preparation and Draping:

• Clean the operative site using an antiseptic solution.

• Drape the limb to maintain a sterile field while allowing visualization of the fracture.

4. Pin Insertion:

• Use fluoroscopic guidance to determine pin placement.

• Make small stab incisions at the planned pin insertion sites.

• Insert Schanz pins (or pediatric-specific half pins) using a drill at a low speed to avoid thermal necrosis.

• Ensure bicortical engagement for stability.

• Place proximal and distal pins parallel to each other in safe anatomical zones to avoid neurovascular injury.

5. Application of Carbon Connecting Plates:

• Choose the appropriate short carbon connecting plates to match the patient’s anatomy.

• Attach the carbon connecting plates to the Schanz pins using compatible clamps.

• Secure the plates at an appropriate distance from the skin to allow for soft tissue swelling.

• Maintain alignment and reduction of the fracture while securing the fixator.

6. Fracture Reduction and Fixation:

• Confirm fracture reduction using fluoroscopy.

• Adjust the clamps and connecting plates to optimize alignment.

• Tighten all fixation elements securely to maintain stability.

• Recheck alignment and stability in different planes.

7. Postoperative Assessment and Closure:

• Verify the final construct stability and alignment under fluoroscopy.

• Irrigate the surgical site with saline.

• Close the skin incisions with sutures or adhesive strips as needed.

• Apply sterile dressings around pin sites to reduce infection risk.

8. Postoperative Management:

• Encourage early mobilization based on fracture stability and patient comfort.

• Instruct caregivers on pin site care to minimize infection risks.

• Schedule regular follow-up appointments for radiographic assessment and fixator adjustments if necessary.

• Plan for staged removal of the external fixator once sufficient healing is achieved.

9. Complications and Precautions:

• Pin tract infections: Monitor for signs of infection and manage with antibiotics or pin site care.

• Loss of alignment: Regular follow-ups to ensure no displacement.

• Neurovascular injury: Proper preoperative planning and careful pin placement to avoid nerve and vessel damage.

• Delayed union or nonunion: Adjust treatment strategy based on bone healing progress.

This technique ensures precise and effective stabilization of pediatric fractures using Orthopedic Carbon Connecting Plates (Short Pediatric) External Fixator, promoting faster healing and early mobilization.

Surgical Technique for Orthopedic Carbon Connecting Plates (Long Adult) External Fixator

1. Introduction The Orthopedic Carbon Connecting Plates (Long Adult) External Fixator is designed to provide stable fixation for complex fractures, deformity corrections, and limb reconstruction. Its lightweight carbon-fiber material ensures radiolucency for precise intraoperative imaging while maintaining strength and durability.

2. Preoperative Planning

• Conduct a thorough clinical evaluation and radiographic assessment (X-rays, CT scans) to determine fracture pattern and optimal fixation strategy.

• Prepare all required instruments and components, including carbon connecting plates, Schanz screws, clamps, and rods.

• Ensure proper sterilization of all instruments and implants.

3. Patient Positioning and Anesthesia

• Position the patient appropriately depending on the limb involved (supine or lateral for lower limb, supine or seated for upper limb).

• Administer regional or general anesthesia per patient requirements and surgical complexity.

• Apply a sterile drape to maintain an aseptic field.

4. Surgical Procedure

4.1. Incision and Initial Pin Placement

• Identify anatomical landmarks and make small stab incisions at predetermined pin insertion sites.

• Use a sharp drill bit to create pilot holes, avoiding neurovascular structures.

• Insert Schanz screws into the bone using a power drill or T-handle until sufficient cortical purchase is achieved.

• Place at least two proximal and two distal screws to ensure stability.

4.2. Frame Assembly

• Attach carbon connecting plates (long) to the inserted Schanz screws using multi-axial clamps.

• Adjust the carbon rods as necessary to achieve alignment and stability.

• Secure the clamps tightly while ensuring optimal spacing between fixation components.

4.3. Final Adjustments and Locking

• Verify alignment using fluoroscopic imaging to confirm reduction and fixator placement.

• Adjust the frame configuration as needed to optimize biomechanical stability.

• Lock all components firmly using a torque wrench to prevent micromovements.

5. Postoperative Management

5.1. Wound Care and Monitoring

• Cover pin sites with sterile dressings.

• Educate the patient on pin-site care to prevent infections.

• Monitor for early signs of complications such as pin tract infections, loosening, or soft tissue irritation.

5.2. Rehabilitation and Weight-Bearing Guidelines

• Encourage early mobilization when feasible.

• Advise on partial or full weight-bearing based on fracture healing status.

• Plan for periodic follow-up X-rays to assess bone healing progress.

5.3. Fixator Removal

• Once radiographic confirmation of fracture healing is achieved, schedule fixator removal under sterile conditions.

• Gradually loosen the clamps and extract Schanz screws carefully.

• Apply compression dressing and monitor for post-removal complications.

6. Complications and Management

• Pin tract infections: Managed with antibiotics and local wound care.

• Frame instability: Ensure all clamps are securely locked and re-tighten if necessary.

• Delayed union or nonunion: Consider bone grafting or alternate fixation strategies if needed.

• Soft tissue irritation: Reposition frame components to avoid excessive pressure on surrounding tissues.

7. Conclusion The Orthopedic Carbon Connecting Plates (Long Adult) External Fixator is an advanced fixation system providing lightweight, rigid, and radiolucent support for complex orthopedic cases. Proper technique, careful intraoperative adjustments, and diligent postoperative care are essential for achieving optimal patient outcomes.

Surgical Technique for Orthopedic Carbon Connecting Plates (Long Pediatric) External Fixator

1. Preoperative Planning:

• Conduct a thorough clinical and radiological assessment to evaluate fracture type, location, and severity.

• Ensure all necessary instruments and implants are available and sterile.

• Obtain informed consent from the patient or guardian, explaining the procedure and possible complications.

2. Patient Positioning:

• Position the patient in a supine or lateral position on a radiolucent operating table, depending on the fracture site.

• Use a tourniquet if necessary to reduce intraoperative bleeding.

• Ensure proper padding to avoid pressure sores.

3. Surgical Approach and Incision:

• Identify the anatomical landmarks and mark pin entry sites under fluoroscopic guidance.

• Make small stab incisions at the planned pin insertion sites to minimize soft tissue trauma.

4. Pin Placement:

• Use a power drill with a sleeve guide to insert Schanz screws or half-pins percutaneously.

• Maintain parallelism and bicortical fixation for better stability.

• Avoid neurovascular structures by following safe corridors.

5. Frame Assembly:

• Select appropriate Carbon Connecting Plates (Long Pediatric) based on the fracture size and configuration.

• Attach the connecting plates to the inserted pins using specialized clamps.

• Adjust the frame to achieve proper alignment and reduction of the fracture.

• Confirm positioning using fluoroscopy.

6. Final Tightening and Stability Check:

• Secure all components firmly to prevent micromovements.

• Reassess fracture reduction and stability under fluoroscopy.

• Perform gentle intraoperative range of motion (ROM) assessment to ensure adequate fixation without impingement.

7. Wound Closure and Dressing:

• Irrigate pin sites with sterile saline to remove debris and prevent infection.

• Close incisions with sutures or adhesive strips.

• Apply sterile dressings around pin sites to minimize contamination.

8. Postoperative Care:

• Initiate early mobilization with weight-bearing as tolerated, depending on the fracture pattern.

• Educate caregivers on proper pin site care to prevent infection.

• Schedule regular follow-up appointments for radiographic assessment and frame adjustments if necessary.

• Plan for gradual removal of the external fixator once adequate healing is achieved, typically 6–12 weeks postoperatively.

9. Complication Management:

• Monitor for pin site infections and treat promptly with antibiotics if needed.

• Assess for any frame instability or loosening and perform adjustments accordingly.

• Address any malalignment issues with corrective interventions as necessary.

By following this structured surgical technique, optimal outcomes can be achieved in pediatric patients requiring external fixation with Carbon Connecting Plates (Long Pediatric).

Surgical Technique for Orthopedic Spinal Arches (Veterinary) External Fixator

1. Introduction The Orthopedic Spinal Arches External Fixator is designed for stabilization and alignment of the spinal column in veterinary patients. This technique provides temporary or long-term support for conditions such as spinal fractures, instability, or deformities.

2. Preoperative Planning

• Conduct a thorough clinical and radiographic evaluation to determine the location and severity of the spinal condition.

• Assess the patient’s neurological status and overall health condition.

• Prepare all necessary instruments, including the spinal arches, connecting rods, clamps, and fixation screws.

• Ensure sterile surgical conditions and anesthesia monitoring equipment.

3. Patient Preparation

• Place the patient in a sternal or lateral recumbency, depending on the affected spinal segment.

• Administer general anesthesia and provide appropriate analgesia.

• Shave and disinfect the surgical site, maintaining aseptic conditions.

• Drape the patient to isolate the surgical field.

4. Surgical Approach

• Make a dorsal midline incision over the affected vertebrae.

• Carefully dissect the paraspinal muscles to expose the vertebral bodies and spinous processes.

• Maintain hemostasis using electrocautery or hemostatic agents.

5. Placement of the Spinal Arches

• Select appropriately sized spinal arches based on radiographic measurements.

• Position the arches symmetrically on either side of the spine, ensuring they do not impinge on neural structures.

• Secure the arches using vertebral fixation screws inserted through the pedicles or laminae.

6. Connecting Rod and Clamp Fixation

• Attach the connecting rods to the spinal arches using adjustable clamps.

• Tighten the clamps gradually, ensuring proper alignment and stability of the affected vertebrae.

• Confirm spinal alignment intraoperatively using fluoroscopy or radiographic imaging.

7. Soft Tissue Closure

• Irrigate the surgical site with sterile saline to remove debris.

• Reapproximate the paraspinal muscles over the fixator without excessive tension.

• Close the subcutaneous layer with absorbable sutures.

• Close the skin using interrupted or continuous sutures.

8. Postoperative Care

• Monitor the patient closely for signs of pain, infection, or neurological deterioration.

• Administer postoperative analgesia and antibiotics as required.

• Encourage controlled movement and rehabilitation as advised by the veterinarian.

• Schedule follow-up radiographs to assess implant stability and bone healing.

• Plan for removal or adjustment of the fixator based on healing progression.

9. Potential Complications

• Infection at the surgical site or around the fixation screws.

• Implant loosening or migration.

• Neurological compromise due to misplacement or excessive compression.

• Delayed or failed spinal fusion.

10. Conclusion The Orthopedic Spinal Arches External Fixator is an effective solution for managing spinal instability in veterinary patients. Proper surgical technique, postoperative care, and timely follow-up are crucial for achieving successful outcomes.

Surgical Technique for Orthopedic Carbon Full Rings (Veterinary) External Fixator

1. Introduction The Orthopedic Carbon Full Ring External Fixator is a versatile and lightweight device designed for stabilizing complex fractures in veterinary orthopedic procedures. Its application is crucial in cases of severe limb fractures, corrective osteotomies, and limb lengthening procedures in animals.

2. Preoperative Planning

• Conduct a thorough clinical and radiographic assessment of the fracture.

• Determine the ring size based on the limb diameter and anatomical location.

• Prepare all required instruments and implants, including carbon full rings, fixation pins, connecting rods, and clamps.

• Perform preoperative blood work and ensure the patient is fit for surgery.

3. Anesthesia and Positioning

• Induce general anesthesia and intubate the patient.

• Position the limb appropriately to allow full access to the surgical site.

• Apply antiseptic solution and drape the surgical area in a sterile manner.

4. Pin Placement and Ring Assembly

• Identify and mark the safe zones for pin insertion using fluoroscopic guidance.

• Utilize a power drill to insert threaded fixation pins percutaneously into the bone, ensuring bicortical purchase.

• Secure the carbon full rings around the limb and attach the fixation pins to the rings using pin clamps.

• Adjust the alignment and spacing of the rings to achieve proper fracture reduction.

5. Connection and Stabilization

• Connect the rings using carbon fiber rods or threaded rods with appropriate locking nuts.

• Verify alignment and stability through fluoroscopic imaging.

• Gradually tighten the assembly, ensuring even distribution of forces.

6. Postoperative Care

• Administer appropriate analgesics and antibiotics.

• Educate the owner on wound care and signs of complications.

• Schedule regular follow-ups for radiographic assessment and fixator adjustments.

• Remove the fixator once radiographic evidence confirms complete bone healing.

7. Complications and Troubleshooting

• Pin Tract Infections: Managed with local antiseptic care and systemic antibiotics.

• Delayed Union: May require additional stabilization or bone grafting.

• Fixator Loosening: Re-tightening or replacement of components as needed.

8. Conclusion The Carbon Full Ring External Fixator provides a stable and adjustable solution for complex veterinary orthopedic cases. Proper surgical technique and diligent postoperative care ensure successful outcomes and optimal fracture healing.

Surgical Technique for Orthopedic Carbon 5/8 Rings (Veterinary) External Fixator

1. Preoperative Planning:

• Conduct a thorough clinical and radiographic assessment to determine the nature and location of the fracture or deformity.

• Prepare the necessary surgical instruments, including the Carbon 5/8 Rings, threaded rods, fixation bolts, and connecting elements.

• Perform preoperative sterilization of all components following standard sterilization protocols.

2. Anesthesia and Patient Preparation:

• Administer general anesthesia and place the patient in the appropriate position for the procedure.

• Shave and disinfect the surgical site to minimize the risk of infection.

• Drape the surgical area with sterile drapes to maintain a sterile field.

3. Ring Placement and Pin Insertion:

• Select the Carbon 5/8 Rings of appropriate diameter to fit around the limb while allowing adequate clearance.

• Make small stab incisions at the planned pin insertion sites to minimize soft tissue trauma.

• Insert Schanz pins or tapered half-pins using a low-speed drill under saline irrigation to prevent thermal necrosis.

• Ensure bicortical engagement of each pin while avoiding neurovascular structures.

• Attach the pins to the Carbon 5/8 Rings using fixation bolts and clamps, ensuring secure anchorage.

4. Construct Assembly and Frame Stabilization:

• Align the rings with the limb and connect them using threaded rods and hinges, if necessary.

• Adjust the frame to achieve optimal fracture alignment and stability.

• Tighten all clamps and bolts securely, ensuring proper load distribution and biomechanical integrity.

5. Postoperative Care and Follow-Up:

• Close skin incisions around the pins with sterile dressings.

• Apply antiseptic to pin sites to minimize the risk of infection.

• Obtain postoperative radiographs to confirm proper alignment and fixation.

• Instruct the owner on postoperative care, including pin site cleaning, restricted weight-bearing, and follow-up evaluations.

• Schedule regular veterinary assessments to monitor bone healing and frame stability.

6. Frame Removal:

• Evaluate radiographic evidence of bone healing before deciding on frame removal.

• Remove the external fixator under sedation or anesthesia following a gradual weight-bearing assessment.

• Manage any pin sites with local wound care to prevent infection and facilitate complete healing.

Conclusion: The Orthopedic Carbon 5/8 Rings (Veterinary) External Fixator provides a highly adaptable and biomechanically stable solution for complex fractures and limb deformities in veterinary patients. Proper technique, meticulous postoperative care, and regular monitoring ensure successful outcomes with minimal complications.

Surgical Technique for Orthopedic Carbon 3/8 Ring (Veterinary) External Fixator

1. Preoperative Planning:

• Conduct a thorough clinical and radiographic evaluation to determine the fracture type, location, and severity.

• Select appropriate ring sizes and components based on the anatomical structure of the animal.

• Prepare a sterile surgical field and ensure all necessary instruments and implants are available.

2. Anesthesia and Positioning:

• Administer general anesthesia and provide adequate analgesia.

• Position the animal to provide optimal access to the affected limb, typically in lateral or dorsal recumbency.

• Apply a tourniquet if necessary to minimize blood loss.

3. Surgical Approach:

• Make a minimal incision at the entry points for the fixation wires or pins.

• Identify and protect vital neurovascular structures to prevent complications.

4. Fixator Assembly and Application:

• Attach the carbon 3/8 rings to the frame and position them according to the fracture configuration.

• Insert smooth or threaded wires through the bone at a 90-degree or 60-degree angle using a hand drill or power drill.

• Secure the wires using fixation bolts and tension appropriately to ensure stability.

• Connect the rings using connecting rods and hinges if required for angular corrections.

• Adjust the frame to achieve proper alignment and stability.

5. Postoperative Assessment:

• Verify alignment and fixation stability using fluoroscopy or radiographs.

• Ensure there is no undue pressure on the soft tissues and neurovascular structures.

6. Postoperative Care:

• Administer antibiotics and analgesics as per veterinary protocol.

• Advise controlled weight-bearing as per the severity of the injury.

• Schedule regular follow-ups for radiographic monitoring and potential adjustments.

• Educate the owner on pin site care and signs of complications such as infection or loosening.

7. Fixator Removal:

• Once sufficient healing is confirmed via radiographs, plan for gradual frame dynamization if required.

• Remove the external fixator under sedation or anesthesia.

• Monitor for any residual gait abnormalities or complications post-removal.

This technique ensures effective stabilization and promotes optimal healing in veterinary orthopedic cases requiring external fixation.

Surgical Technique for Orthopedic Carbon Foot Rings Short (Adult) External Fixator

1. Preoperative Planning:

• Evaluate the patient's condition and determine the need for external fixation.

• Conduct radiographic imaging to assess fracture pattern and alignment.

• Prepare the surgical plan, including the ring configuration and pin placement.

2. Patient Positioning:

• Place the patient in a supine position on a radiolucent operating table.

• Ensure proper limb support to maintain alignment during the procedure.

3. Anesthesia:

• Administer regional or general anesthesia based on the patient’s condition and surgical complexity.

4. Surgical Approach:

• Perform a thorough sterile preparation and draping of the limb.

• Identify anatomical landmarks for pin placement.

5. Ring Assembly and Application:

• Assemble the Carbon Foot Rings Short to form a stable frame.

• Position the frame appropriately around the foot, ensuring alignment with the anatomical axis.

• Secure the rings using connecting rods and hinges if necessary for dynamic correction.

6. Pin and Wire Insertion:

• Select appropriate-sized Schanz pins and Kirschner wires.

• Use a drill to insert the pins and wires at predetermined points, avoiding neurovascular structures.

• Secure the wires with tensioners to provide adequate stability.

• Attach the pins to the frame using clamps and bolts, ensuring firm fixation.

7. Frame Adjustment and Alignment:

• Verify limb alignment under fluoroscopic guidance.

• Adjust the frame as needed to ensure correct reduction of the fracture or deformity.

• Tighten all fixation elements to enhance construct stability.

8. Postoperative Assessment:

• Confirm alignment and stability using intraoperative fluoroscopy.

• Apply sterile dressings to pin sites to prevent infection.

9. Postoperative Care and Follow-Up:

• Initiate weight-bearing as per surgeon’s discretion and patient tolerance.

• Monitor for signs of infection, loosening, or misalignment.

• Schedule regular follow-ups for frame adjustments and healing assessment using radiographs.

• Educate the patient on pin-site care and activity limitations.

• Plan for gradual frame removal once the fracture or deformity is healed.

10. Complication Management:

• Address pin tract infections with local wound care and antibiotics.

• Manage malalignment or loosening with frame adjustments.

• Ensure timely removal of the fixator to prevent joint stiffness and complications.

This technique ensures effective stabilization of foot injuries or deformities using the Carbon Foot Rings Short External Fixator while optimizing patient recovery and functional outcomes.