External fixation may look very high-tech, and maybe even scary. However, external fixation has been used in one way or another since almost 2400 years ago. External fixation techniques were described by Hippocrates, and were used in treating tibia fractures. External fixation is a minimally invasive technique to reduce displaced fractures.
Jean François Malgaigne was one of the many pioneers that made advancements with external fixation devices. In 1846, Malgaigne used a device that consisted of a clamp and four metal prongs to reduce and stabilize a fracture of the patella, or kneecap. Following this external fixation device many other similar inventions were used to treat fractures in various locations. In 1938, Raoul Hoffman made advancements that made external fixation even more useful, and allowed surgeons to place pins into a fracture for stabilization with guidance, while being minimally invasive. In 1951, Dr. Gavriil A. Ilizarov developed the external fixation device that is still in use today. Ilizarov’s fixation device consists of a metal frame that encircles the limb, and is attached to underlying bone by pins. Threaded rods and hinges allow movement of the bone to the correct alignment. Ilizarov’s external fixator is great because adjustments can be made without opening the fracture site, and the device provides stability.
Modern day external fixation not only provides stability to a fracture, but can also be used for soft tissue deformities, as well as other bony deformities. External fixation is preferred when slow correction is wanted. The chance of getting a blood clot is lessened because with external fixation patients can be partial weight bearing, or weight bearing as tolerated following the procedure due to the stability that the fixation provides. External fixators have been used for other bony deformities, such as Charcot, ankle arthritis, and clubfoot. External fixation can also be used to lengthen amputated foot and toe stumps. External fixation has definitely helped many people, but there are still some cons. Pain and infections are two issues associated with external fixation, and rates vary depending on the extent of the procedure, and the location of the device. External fixation devices are used by many Podiatrists for treating many different ailments, and have been crucial to shaping the Podiatry and Orthopedic professions.
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