Going Home in an External Fixator

An external skeletal fixation system is used to treat broken bones (fractures), bones and joints that are positioned so they don’t work effectively (improper alignment) and bones in arms and legs that are different lengths (limb length inequality). The device is placed outside of the arm, leg, foot or hand and fastened to your bones.

Different types of fixators are used depending on the location and problem being treated. The device may be unilateral (one sided), bilateral (two sided), or circular (all the way around the extremity).

Once your doctor has decided which device you will need, you will be scheduled for surgery. During surgery your doctor will attach the fixator to your arm, leg, hand or foot with pins or wires.

Your length of stay in the hospital will depend on where you live and how quickly you progress. Most patients stay in the hospital from two to three days.

The length of time you wear your device depends on your procedure. Everyone is different. For patients having a lengthening procedure, the bone stretches 1 mm each day. For example it takes 25 days to lengthen a bone 1 full inch.

After the lengthening goal is reached the healing process can begin. Your progress will be monitored through x- rays. Once the bone is strong enough, the device can be removed. Most external fixator devices are worn for a minimum of three to four months. Again, this will be different for each patient.

As with any surgery, a certain level of pain is expected. Having a device applied may be painful. Your doctor will order medicine to reduce the pain for you to use both at the hospital and at home.

Before you leave the hospital you will learn how to take care of your device. You will be taught how to perform required lengthening and cleaning procedures. By the time you are discharged you will feel comfortable taking care of your device at home. Our team of nurses, child life specialists, and therapists will work with you on device lengthening, medical treatments, physical activity, and pain management. They will also give you a turning schedule. Our goal is to make certain you leave the hospital confident in your ability to take care of yourself while you are wearing the device. It is important that you share your concerns with us.

While you are in the hospital, you will be given a vigorous program of physical therapy to strengthen your growing bone and help it heal. Before you leave the hospital a physical therapist will develop a personalized home program for you. You will be expected to perform range of motion and strengthening exercises each day until your device is removed. When you follow your therapy program closely, you are strengthening your bone and promoting healing.

You will be required to have regular doctor visits in the Outpatient Clinic to closely monitor your progress. You will be allowed to go to school in your device. There will be some limitations on activity but we encourage keeping as normal of a routine as possible. The most important consideration is your safety. You should avoid activities that could injury your extremity or expose you to an infection. Talk with your Care Coordinator about special accommodations you might need.

Your clothing will need to be modified to fit over your device. Buying larger sizes or clothing equipped with Velcro or snaps allows for easier dressing. Because metal is sensitive to heat and cold, you will want to keep your device covered when you are outside.