Vet360 Vet360 Volume 4 Issue 5 | Page 15

SURGERY
a great bone to place an ESF in the case of severely comminuted distal humeral fractures ( Figure 6 ). The distal humerus is the ideal place for a full pin , which will generally last a lifetime before it loosens .
The femur does not tolerate ESF very well . The distal as well as the proximal femur will generally always lead to high pin complications and pin loosening ; the method can still be used in the femur but should not be the first choice .
Some neurologists apply ring fixators with hall pins to the spine as a first choice fixation to spinal fractures . This is done under fluoroscopy . Specific large spinal rings are available for this surgery .
Pelvis fractures have also been repaired using ESF , however it is not the first choice given the high incidence of pin tract complications .
Fixators are useful for open mandible fractures but once again there are other options like interdental wiring and acrylic that would be a first choice .
In conclusion ESF ’ s are fantastic for repair of simple to challenging fractures in all sizes of patients . However if not applied correctly in line with basic principles they can lead to catastrophic failures of fracture repair . The reality of the newer systems is that if applied correctly they tend to cost the same as a plate and screws . The main cost being the threaded pins as the clamps and connecting bars are re-useable up to a point .
References :
• Imex Course Note From Complete Course Of Linear And Hybrid Fixation . Fort Worth Dallas 2015 .
• External Skeletal fixation in Veterinary Surgery small animals by Tobias and Johnston .
Figure 6 . Circular hybrid ESF for arthrodesis of the tarsal joint
Figure 6 . Circular hybrid ESF of the humerus
Issue 05 | OCTOBER 2017 | 15