The Threaded External Fixator in Children and Adolescents. Technique. Clinical Examples

Abstract

The majority of fixations in pediatric orthopedics are accomplished by means of a plaster cast or Kirschner wires. Internal fixations with cerclage wire, lag screws, plates, etc. are rarely indicated. In certain cases, however, pediatric osteotomies and fractures have been managed with the aid of external skeletal fixation, as in adults. We, too, employ both unilateral and bilateral external frames in certain of our pediatric patients as a means of effecting compression, neutralization or distraction. We find external fixation particularly useful for the conduct of staged corrective procedures. With the threaded external fixator, staged corrections can be carried out easily and conveniently over a period of several days. A gradual approach of this type is indicated in all cases where the proposed correction carries a significant risk of neurovascular injury. It will give the neurovascular bundles an opportunity to adapt, while exerting a gradual yet effective stretching action on the shortened muscles.