The fracture on the left has been stabilised using the external fixator as a `scaffolding'. This supports the healing bone until it possesses enough strength to allow the fixator to be removed. The bar is external to the skin and the pins penetrate the bone by passing through the skin. This means that you may see more metal than you would like!

External fixators come in all shapes and sizes depending on the type of fracture that is being treated. As such they are extremely versatile.

In general you shouldn't have to maintain the fixator at all. Occasionally however there is some discharge from one or more of the pins. This is usually the result of the skin moving against the pin and provoking a reaction. In this case gentle cleansing with dilute Savlon on a cotton bud is all that is required. If you are worried please contact me and I will be happy to advise you. One other potential problem is a consequence of limb swelling which results in the clamp contacting the skin and ulcerating the skin. Should this occur please telephone.

Most patients with a fixator will be happy to use the limb within 10 to 14 days. This is a mixed blessing! As with all metal (in aeroplanes etc) repeated stress such as loading and unloading can produce metal fatigue. This `cyclic stressing' of the limb can also cause loosening of the pins. For these reasons it is important to minimise exercise.

In the first two weeks your dog should be taken to the garden on the lead to do his `business' and stretch his legs a little. This can be extended to 5 minutes exercise 2 to 4 times daily from two to four weeks. In second month, exercise sessions of up to 15 minutes three times daily on the lead at all times can be instituted. Free play and uncontrolled exercise should not be permitted whilst the fixator is in place.

Following removal of the fixator this level of exercise should be continued for 14 days, and then gradually returned to normal over 4 weeks.

The fracture on the left is unstable. This will produce pain and will prevent accurate anatomic healing. The leg would shorten as a result of muscle contracture resulting most likely in a useless limb. All surgical methods employed in the fixation of fractures attempt to address this instability by providing rigidity to the fracture. This allows the fracture to heal in an anatomic or functional position and prevents limb shortening. Using casts and splints will often cause problems in the joints above and below the fracture. That is why we tend to use metal implants.

Callus or soft bone forms in between the fracture ends. This healing tissue will transform into bone over 8 to 12 weeks. For this reason the external fixator will remain in place for this length of time. Occasionally the fixator has to be weakened (`staged down') in order to speed up the healing process and give strength to the soft bone. For these reasons it is often necessary to X-ray your pet at 4, 8 and 12 weeks in order to assess healing and adjust the fixator. This requires a general anaesthetic. When healing is complete the fixator is removed