When treating a fracture, your healthcare provider might place an external fixator, also known as an ex fix, to keep the injured bones stable and in place.
Bear in mind, though, that these external fixators are mechanical devices that need to be taken care of for the duration of the process.
What Is an External Fixator?
An external fixator is a frame made of metal that keeps your bones in place. Pins from the ex fix are inserted through your skin and into your bones to help them heal or grow, and they may be inserted into your leg, foot, arm, or hand.
The device will be made of the following parts:
- Large, solid pins that are screwed into your bone
- Thin, smooth wires that go from one side of your bone to the other
- Metal, braided cables that adjust your bones
- Rings that circle your external fixators to keep them in place
- Long straight rails, usually used on an external fixator placed on your thigh or arm
- Clickers that adjust your bone when pulled on
External Fixator Adjustment
After getting your external fixator, you’ll need to adjust it a couple of times each day to make sure that your bones heal or grow as they should. You can do this yourself by turning pieces of the structure with a special wrench that your healthcare provider will give to you.
Your healthcare provider will show you how to adjust the ex fix – be sure to follow their instructions carefully. They will explain your distraction rate to you. Your distraction rate is the amount that you need to adjust the frame; every 24 hours you’ll need to adjust it between one and six times. You must follow your adjustment schedule if you want your bones to heal or grow correctly.
If you don’t remember to make adjustments, reach out to your healthcare provider immediately. Don’t try to make up for forgotten adjustments by performing too many adjustments in a short period of time. If the adjustments start to hurt or become problematic in some way, get in touch with your healthcare provider.
Living With an External Fixator
Everyday activities can be a little more difficult when you have an ex fix! Don’t let this metal frame keep you from leading your life, though. Staying active, spending time with loved ones, and doing things you enjoy are all important aspects of recovery.
Consider the following tips to help make day-to-day tasks a little easier:
- Plan ahead when leaving the house. Learn what your destination offers in terms of accessibility and if you need to bring someone to help you get around.
- Sit when doing household chores. If possible, take a seat while cooking, doing laundry, getting ready, and more.
- Use a shower chair or sit on the ground while showering. Avoid bathing, if possible. If you’re worried about scratching your bath or shower with a chair, place a towel or non-slip mat down to protect the floor.
- Place spare pillows under or around your recovering limb while you sleep to keep it still and to form a barrier so the rest of your body doesn’t rub against it.
- Try wearing sweats with zippers or snaps on their legs if your clothes don’t fit over your ex fix. Consider wearing oversized shirts, shorts, skirts, or specially made clothing.
- Cover the metal frame during sex to keep your partner’s skin safe from harm. Try a variety of positions depending on where your ex fix is located.
- Avoid swimming in public pools, the ocean, or other large bodies of water in an effort to keep your external fixator’s entry sites clean.
External Fixator Care
Right after your ex fix is attached, you’ll have gauze covering the pin, wire, and cable sites. At your first follow-up appointment, the gauze will be removed, and you will need to start cleaning the sites every day to prevent infections, protect your skin, prevent drainage, and reduce irritation. You’ll need to clean the sites with cotton balls or Q-tips, povidone-iodine or bacitracin, gauze, antibacterial soap, and water. Specifically, you will need to:
- Wash your hands with soap and water.
- Mix some water and a small amount of antibacterial soap in a container.
- Pour a bit of povidone-iodine or bacitracin into another container.
- Dunk your cotton applicator into the water and soap.
- Clean each site, focusing on loose skin tissue and scabs stuck to your pins, wires, or cables.
- Place a new cotton applicator into the povidone-iodine or bacitracin.
- Clean each site again and wait a few minutes for them to dry.
If bacteria from one site makes its way to another site, that can cause an infection. You should throw cotton applicators away after using them to clean one site, and you should never dip a used applicator into the liquids. If you use gloves, gauze, tweezers, or anything else to help clean the sites, make sure to clean them in between cleaning each site.
External Fixator Infection
Parts of your external fixator go straight through your skin and into your bone, which increases the opportunity for infection. Cleaning all entry sites is important in preventing this from happening.
If you’re diligent about cleaning and caring for your external fixator, you’ll still probably get a few infections. External fixator infections are common and typically simple to cure, though.
Signs of an infection include:
- New pain
- Redness
- Thick, yellow substance
- Unusual smell
If you have symptoms of an infection, get in touch with your healthcare provider. They might recommend wrapping the site in a povidone-iodine wrap, soaking your limb in magnesium sulfate, or taking an antibiotic.
When to Call the Healthcare Provider
Some signs of infection are more serious than others, including:
- A fever above 101.3 ℉
- Swelling around the sites
- Feeling like the skin around the sites is full of fluid
- A bad smell
Deeper infections may require an IV that pumps antibiotics straight through your veins or surgery that cleans and adjusts your pins. Reach out to your healthcare provider immediately if you experience any of these symptoms or if you feel that something is not right with your external fixator.