Authors of section

Author

Anton Fürst

Executive Editor

Jörg Auer

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Pinless external fixator

1. Principles

Fixator clamps

There are two different types of clamps for the pinless fixator: symmetric and asymmetric clamps.
Depending on the configuration of the mandible, either the symmetric or the asymmetric clamp are used.

pinless external fixator

2. Preparation and approach

This procedure is performed with the patient standing or placed in dorsal recumbency using stab incisions for the external fixator.

3. Wound debridement

Fractures of the interdental space and horizontal ramus are almost always open fractures. Wound debridement and flushing is extremely important. Nevertheless, infections of soft tissues as well as the bone are common. Therefore, establishment of ventral drainage is important.

In older or infected fractures, wound débridement is important. All infected bone must be removed with a curette or rongeur.

Additional flushing is indicated.

pinless external fixator

4. Surgical technique

Stab incisions are made in the soft tissue and the tips of the bone clamps are embedded in the mandibular cortex by an applicator instrument.

stab incisions external fixator

Once the clamp is fixed in position, a connecting rods is applied to the bone clamp.

stab incisions external fixator

The clamp is fixed to the connecting rod and finally, the side bar is attached.

mandible horizontal ramus interdental space unilateral

Fixation of an open and infected mandibular fracture using a pinless fixator.
The bar and the clamps are padded to prevent inadvertently being caught on objects in the horses environment.

pinless external fixator

5. Aftercare

During the post-surgical period, the horse is confined to stall rest for one week. They should be housed in smooth walled stalls. Mangers, grates and gate latches represent hazards to the horse fitted with an external fixator.
The horse should be fed from the floor with soft fiber feed stuff; firm feed such as hay cubes, apples or carrots should not be fed. Crossbars may be bandaged or the horse fitted with a padded recovery hood to protect the fixator from entrapment and disruption.

Pinless fixator 10 days after application

Antibiotics and anti-inflammatory drugs are given for 3 to 5 days or longer, if required, especially in open fractures. Daily pin track care is recommend to prevent infection.
Follow up radiographs are taken at about 8 weeks after surgery. Once the fracture is healed, the fixator is removed.

Pinless fixator 6 weeks after surgery