External Fixation

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Things you need to know

1.What is External Fixation ​?
2.Why do you need it?
3.Why cost vary in philippines?
4.Surgery cost range by city
5.Surgery Procedure
6.Recovery
7.Risk and complications
8.FAQ
9.Conclusion

What is External Fixation ?

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Why do you need External Fixation ?

External fixation is indicated for:

  • Complex fractures:
    • Open fractures: Bone exposed, high infection risk (e.g., tibia, femur).
    • Comminuted fractures: Bone shattered into multiple fragments.
  • Infections:
    • Osteomyelitis: Bone infection requiring stabilization during treatment.
  • Deformity correction:
    • Bone malunion/nonunion: Fractures healed incorrectly or not healed.
    • Limb length discrepancy: Gradual lengthening using distraction osteogenesis (e.g., Ilizarov frame).
  • Trauma:
    • Temporary stabilization in polytrauma patients (e.g., pelvis, long bones).
  • Pediatric cases:
    • Growth plate injuries or congenital deformities (e.g., clubfoot correction).

The procedure aims to stabilize the bone, promote healing, or correct alignment by using an external frame (e.g., Ilizarov, uniplanar, or hybrid fixators), allowing controlled movement or lengthening while minimizing infection risk.

Why Do External Fixation Costs Vary in Philippines?

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External Fixation Procedure

  • Before Surgery Evaluation:
    • Diagnosis:
      • X-ray/ct: Assesses fracture type, alignment, and bone fragments.
      • Blood tests: Blood sugar, infection markers (e.g., CRP, ESR for osteomyelitis).
      • Soft tissue evaluation: Checks for open wounds or infection.
    • Medications: Stop blood thinners (e.g., aspirin) 5–7 days prior if safe; antibiotics (e.g., cefazolin) given pre-op for open fractures.
    • Consent: Risks, including infection, are explained.
  • Surgical Techniques:
    • External Fixation:
      • Performed under general or regional anesthesia (e.g., spinal), lasting 1–3 hours depending on complexity.
      • Pins or wires (e.g., Schanz pins, K-wires) are inserted through the bone above and below the fracture/deformity site.
      • The pins/wires are attached to an external frame (e.g., Ilizarov circular frame, uniplanar fixator, or Taylor Spatial Frame).
      • Frame components (rods, rings, hinges) are adjusted to stabilize the bone or allow controlled lengthening/correction.
      • For lengthening: Distraction osteogenesis begins 5–7 days post-surgery (1 mm/day adjustment).
      • Open wounds (if present) are cleaned and dressed; temporary fixators may later be converted to internal fixation.
    • Intraoperative Tools:
      • Fluoroscopy: Real-time X-ray to guide pin placement.
      • External fixator system: Stabilizes bone (e.g., Ilizarov frame).
      • Drill: Inserts pins/wires into bone.
  • After Surgery:
    • Hospital stay: 2–5 days (longer for complex cases or infections).
    • Care: Pin sites cleaned daily with saline or antiseptic (e.g., chlorhexidine); antibiotics continued if infection present.
    • Pain management: Moderate pain for 3–7 days; managed with analgesics (e.g., paracetamol, tramadol).
    • Instructions: Partial weight-bearing with crutches (varies by site); avoid getting frame wet; adjust frame as instructed (e.g., for lengthening).

Recovery After External Fixation

  1. Hospital Stay: 2–5 days.
  2. Post-Surgery Care:
    • Pain/Swelling: Peaks at 3–7 days; ice and elevation help; resolves in 2–3 weeks.
    • Pin site care: Clean daily to prevent infection; crusting or redness may need antibiotics.
    • Mobility: Partial weight-bearing with crutches (e.g., tibia: 6–12 weeks); full weight-bearing after bone healing (3–6 months).
    • Frame adjustments: For lengthening/deformity correction, daily adjustments (1 mm/day); total duration 3–12 months.
    • Physiotherapy: Starts at 2–4 weeks; focuses on joint mobility, muscle strength; continues 3–6 months.
    • Frame removal: After bone healing (3–12 months); minor procedure under anesthesia (additional cost: ₹10,000–₹30,000).
  3. Follow-Up:
    • Visits every 2–4 weeks to monitor healing, adjust frame, and check for infection.
    • X-ray: Monthly to assess bone healing (callus formation).

Most resume normal activities in 3–6 months (after frame removal); full recovery (including sports) takes 6–12 months. Success rate: 85–90% achieve bone healing; deformity correction varies (70–95%).

Risks and Complications

  • Surgical Risks:
    • Infection (10–20%): Pin site infections common; treated with antibiotics; deep infection (osteomyelitis) may need frame removal.
    • Bleeding (1–3%): Hematoma around pins; may need drainage.
    • Nerve/vessel injury (<1%): Pin placement may damage nearby structures; rare with fluoroscopy.
  • Post-Surgery:
    • Pin loosening (5–10%): May need pin replacement or frame adjustment.
    • Delayed healing (5–15%): Nonunion or slow union; may need bone grafting.
    • Joint stiffness (10–20%): Limited motion (e.g., ankle, knee); managed with physiotherapy.
    • Refracture (2–5%): After frame removal; requires prolonged protection.
  • Long-Term:
    • Chronic pain (5–10%): At pin sites or fracture; usually resolves in 6–12 months.
    • Limb length discrepancy (2–5%): If lengthening over/undershot; may need additional correction.

Report fever, severe pain, swelling, or pus at pin sites promptly.

Frequently Asked Questions (FAQs)

When is external fixation needed?

For complex/open fractures, infections, nonunions, or deformity correction when internal fixation isn’t suitable.

Can I avoid external fixation?

Sometimes; internal fixation (plates/screws) or casting may suffice for simpler fractures; external fixation is for high-risk or complex cases.

Is external fixation painful?

Moderate pain for 3–7 days post-surgery, managed with medication; pin site discomfort may persist.

How soon can I resume activities?

Partial weight-bearing in 6–12 weeks; normal activities in 3–6 months; full recovery in 6–12 months.

Is external fixation covered by insurance in India?

Yes, for medical necessity; confirm with your provider.

Signs of complications?

Fever, severe pain, swelling, or pus at pin sites.

How long will the frame stay on?

3–12 months, depending on healing or correction goals; removed after bone consolidation.

Lifestyle changes post-surgery?

Keep pin sites clean, avoid getting frame wet, follow weight-bearing instructions, attend physiotherapy, and monitor for infection.

Conclusion

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Looking for Best Hospitals for External Fixation

Note: we are not promoting any hospitals

We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)

  • click on your city and schedule your surgery now done in good hands.
City Minimum Price (₱) Maximum Price (₱)
Angeles City
Antipolo
Bacolod
Bacoor
Baguio
Butuan
Cagayan de Oro
Caloocan
Cebu City
Dasmariñas
Davao City
General Santos
General Trias
Iligan
Iloilo City
Las Piñas
Makati
Malolos
Manila
Muntinlupa
Parañaque
Pasay
Pasig
Puerto Princesa
Quezon City
San Fernando
San Jose del Monte
Taguig
Valenzuela
Zamboanga City

Disclaimer

This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.

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