A Patient's Guide to External Fixation for Bone Correction and Lengthening :: Royal National Orthopaedic Hospital

发布时间：2025-09-18 10:03

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Pin site infection
The most common complication of having an external fixator is pin site infection.

Symptoms of a pin site infection may include:

• Increased pain in the area
• Spreading redness of the skin
• Increased discharge or pus (not always present)
• Increased swelling
• Difficulty weight bearing
• You have a temperature or feel unwell.

Pin site infections are treated with oral antibiotics in the first instance. If you suspect you have an infection you should visit your GP at the earliest opportunity for assessment and if necessary, the prescription of antibiotics. It is important that you complete a course of antibiotics once started. If your infection does not respond to antibiotics prescribed by the GP you should contact a member of the Limb Reconstruction Team.

Meticulous pin site care will minimize the risk of pin site infection. You will be shown how to care for your pin sites as well as have some practice whilst you are in hospital. If necessary, we may arrange for some nursing support in the community once you are discharged from hospital.

Joint Stiffness and soft tissue tightness
This can be a problem and may affect your ability to mobilise. It is of prime importance that you perform the exercises that the Physiotherapists provide, or wear any necessary splints as instructed. In severe cases, surgery may be required to release tightness in the soft tissues to allow a full range of movement.

Joint Instability
Following long lengthening procedures there is a small risk of dislocation of the surrounding joint. This particularly applies to the hip and the knee when lengthening a femur and to the knee when lengthening a tibia. This is monitored during the lengthening process and whilst it may be prevented with aggressive physiotherapy, its occurrence may lead to abandoning further lengthening.

Nerve and blood vessel injury
Rarely nerves and blood vessels can become damaged. This can be either at the time of surgery or during the subsequent lengthening or repositioning of the bone. You should inform nursing and/ or medical staff if you experience pain, numbness or pins and needles. Should this occur during the lengthening process this may mean that we slow down the rate of adjustment or even stop lengthening. Usually this wears off, but in some cases it may become permanent. It is important that you inform a member of the Limb Reconstruction Team should these symptoms occur.

Acute Compartment Syndrome
Acute Compartment Syndrome is a painful condition that occurs when swelling or bleeding causes increased pressure within the muscle compartments. It will usually be diagnosed and treated when you are already in hospital, however, it can occur several days after surgery.

The main symptoms are:
• Severe pain which is constant. The pain may worsen upon movement when the muscles are stretched.
• Tingling or burning sensation in the area.
• The skin in the affected area may become pale, cold, tense and hard
• Reduced strength and movement in the affected area

Acute compartment syndrome is a medical emergency. If you experience any of these signs or symptoms, you should inform a member of your consultant’s team or attend your local accident and emergency department immediately.

Further information about Acute Compartment Syndrome can be found in the page:

‘A patients’ guide to Acute Compartment Syndrome’

Deep Vein Thrombosis (DVT)
There is a risk of developing a DVT. This is a blood clot which is treated by medication that thins the blood. Your risk factors for this occurring will be assessed by medical staff and if necessary you will be placed on anticoagulation therapy.

Pressure Ulcers
A pressure ulcer is damage to the skin and underlying tissue. They can be caused by pressure, shear or friction.

Pressure ulcers tend to form where bone causes the greatest force on the skin. This is caused when the body is in contact with the mattress, chair or another part of the body. Areas such as the bottom, heel, hip, elbow, ankle, shoulder, back and the back of the head are vulnerable.

They can also be caused if your limb swells excessively within the external fixator causing the skin to be in contact with the clips holding dressings in place or the rings or bars of the fixator.

Further information can be found in the leaflet:

‘A patients’ guide to pressure ulcer prevention’

Failure to gain length/delayed union
This may occur if the bone does not form during lengthening or takes a long time to mature. Other reasons for failure to gain length relate to problems with stretching the nerves, blood vessels and tendons. Your consultant will advise you about treatments should this arise.

Problems with the fixator
Rarely the wires or half pins which attach the fixator to your limb may lose tension or break. If this were to occur, the frame may seem unstable or the pin site become more painful. Should you be concerned regarding this please contact a member of the Limb Reconstruction Team. We may replace, repair or remove a broken wire depending on the stage of treatment.

Refracture
Following removal of the external fixator, fractures are a rare problem. If this were to occur it would possibly require further surgery or a period in a cast or brace.

Can I be worse off?
The worse case scenario is that if there was an uncontrolled infection, damage to the arteries and nerves or interruption of the blood supply to the muscles, there is a risk that this could lead to amputation of the limb.

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A Patient's Guide to External Fixation for Bone Correction and Lengthening :: Royal National Orthopaedic Hospital

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