Description

Mini External Fixator

M&A

Q1: What is a Micro fixator Straight and what are its primary indications?
A1: A Microfixator Straight is a miniaturized external fixation system designed specifically for hand surgery. It is primarily used to stabilize complex fractures, replanted digits, and correct deformities in the fingers (phalanges) and metacarpals, providing rigid fixation while allowing for soft tissue care and early mobilization.

Q2: How does the micro fixator’s design accommodate the unique anatomy of the hand?
A2: Its design features low-profile, lightweight components, and utilizes very fine pins (typically 1.5mm to 2.5mm in diameter) to minimize soft tissue trauma, tendon tethering, and joint impingement in the confined anatomical space of the hand.

Q3: What are the key advantages of using micro external fixator in the hand compared to internal fixation?
A3: Key advantages include:

Minimal Soft Tissue Disruption: No need for extensive dissection, preserving blood supply.

Versatility: Can be applied to comminuted fractures where internal fixation is not feasible.

Access for Wound Care: Ideal for open fractures or injuries with significant soft tissue loss.

Adjustability: Alignment can be fine-tuned after application.

Q4: What is the most common complication, and how is it managed?
A4: Pin tract infection is the most frequent complication. Management involves meticulous pin site care, oral antibiotics for superficial infections, and rarely, pin removal or replacement for deep infections.

Q5: How is the hand trauma fixator applied surgically?
A5: Under fluoroscopic guidance, pins are drilled into the stable bone fragments proximal and distal to the injury. The straight rod is then connected to these pins using low-profile clamps, creating a stable “bridge” across the fracture site without crossing the joint whenever possible.

Q6: Can patients move their fingers with micro fixator in place?
A6: Yes, a significant advantage is that it allows for early controlled mobilization of the adjacent joints. This is crucial for preventing stiffness and promoting tendon gliding, which is a primary goal in hand rehabilitation.

Q7: How long is the hand external fixator typically left on?
A7: The duration is typically 4 to 6 weeks, depending on the fracture complexity and evidence of healing on follow-up X-rays. The goal is to remove it as soon as there is sufficient stability to prevent stiffness.

Q8: What are the specific challenges during application?
A8: Challenges include:

Avoiding delicate neurovascular structures and tendons during pin placement.

Achieving stable fixation in small bone fragments.

Constructing a frame that is rigid yet does not impede function or snag on objects.

Q9: What post-operative care and rehabilitation are required for Micro External Fixator?
A9: Essential post-operative care includes:

Elevation to control swelling.

Daily pin site cleaning with saline or antiseptic.

Immediate occupational therapy for edema control and active/passive range of motion exercises of the uninvolved joints.

Q10: When is Micro External Fixator the best choice over K-wires or plating?
A10: It is the best choice in scenarios such as:

Severe comminution where screws cannot get adequate purchase.

Open fractures with contamination where placing a large metal implant is risky.

Articular fractures requiring ligamentotaxis (indirect reduction by ligament traction).

Digital replantation to provide stability without compromising vascular anastomoses.