HSS Journal

, Volume 3, Issue 1, pp 13–29

The Mechanics of External Fixation

Original Article

DOI: 10.1007/s11420-006-9025-0

Cite this article as:
Fragomen, A.T. & Rozbruch, S.R. HSS Jrnl (2007) 3: 13. doi:10.1007/s11420-006-9025-0


External fixation has evolved from being used primarily as a last resort fixation method to becoming a main stream technique used to treat a myriad of bone and soft tissue pathologies. Techniques in limb reconstruction continue to advance largely as a result of the use of these external devices. A thorough understanding of the biomechanical principles of external fixation is useful for all orthopedic surgeons as most will have to occasionally mount a fixator throughout their career. In this review, various types of external fixators and their common clinical applications are described with a focus on unilateral and circular frames. The biomechanical principles that govern bony and fixator stability are reviewed as well as the recommended techniques for applying external fixators to maximize stability. Additionally, we have illustrated methods for managing patients while they are in the external frames to facilitate function and shorten treatment duration.

Key words

Ilizarov reconstruction external fixation biomechanics trauma deformity limb lengthening 

Copyright information

© Hospital for Special Surgery 2006

Authors and Affiliations

  1. 1.Hospital for Special SurgeryWeill Medical College of Cornell University, Limb Lengthening and Reconstruction InstituteNew YorkUSA

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