The Journal of Bone and Joint Surgery (American). 2007;89:1620-1632.
© 2007 The Journal of Bone and Joint Surgery, Inc.
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Instructional Course Lecture

External Fixation: How to Make It Work

Bruce H. Ziran, MD1, Wade R. Smith, MD2, Jeff O. Anglen, MD3 and Paul Tornetta, III, MD4

1 Northeastern Ohio Universities College of Medicine, St. Elizabeth Health Center, 1044 Belmont Avenue, Youngstown, OH 44501. E-mail address: Bruce_Ziran@hmis.org
2 Department of Orthopaedics, Denver Health Medical Center, 777 Bannock Street, Denver, CO 80204
3 Department of Orthopaedics, Indiana University, 541 Clinical Drive, Suite 600, Indianapolis, IN 46202
4 Department of Orthopaedic Surgery, Boston Medical Center, 850 Harrison Avenue, D2N, Boston, MA 02118

An Instructional Course Lecture, American Academy of Orthopaedic Surgeons

The first 150 words of the full text of this article appear below.


   Introduction
 
The external fixator has been in use for more than a century. The first use was recorded by Carl Wilhelm Wutzer (1789-1863), who employed pins and an interconnecting rod-and-clamp system. Parkhill (1897) and Lambotte (1900) used devices that were unilateral with four pins and a bar-clamp system. By 1960, Vidal and Hoffmann had popularized the use of an external fixator to treat open fractures and infected pseudarthroses. The problems encountered with external fixation in the late twentieth century were predominantly due to a lack of understanding of the principles of application, the principles of fracture-healing with external fixation, and the use of old technology. Its use was reserved for the most severe injuries and for cases complicated by infection. Thus, pin problems, nonunions, and malunions were common. Since then, better technology and understanding have allowed for greater versatility and better outcomes. Simultaneous with developments in the Western . . . [Full Text of this Article]


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