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The following information is a general overview on external fixation. Please discuss with our surgeon about your specific case for more details.


When is a circular external fixation (such as Ilizarov or hexapod frame) used?

External fixation is usually reserved for cases involving major limb trauma and severe soft tissue injuries where other methods of treatment are not possible, to correct bone deformities (e.g. when a bone has healed at an abnormal position/angle), to correct leg length, to treat bone infection, or bone that has not healed (we call this "non-union").


How long does the external fixator stay on for?

The frame can stay on for approximately 4-6 months. The time it takes varies depending on the reason the frame was applied for in the first place, the patient's medical condition, the progress made in the frame, and most importantly if the patient smokes or not - smoking has a negative effect on bone healing and can prolong the time the frame stays on as a result.


Is it painful to have the external fixation on the leg?

Not more so than other operations in general. Typically, the first few days may be painful and this usually requires strong painkillers given whilst still in hospital. Once the pain settles, it is not painful to have the external fixator attached to the limb.


What are the possible complications?

Because the external fixators are often used in very severe trauma where there is significant damage to the bone, joint surfaces, soft tissues, and nerves ad vessels, there are inherently high risks and complications related to the initial injury itself. General risks include infection (commonly a pin-site infection or very rarely deep infection), nerve injury, bleeding, anaesthetic-related complications, joint stiffness, chronic pain, failure of treatment, loss of function, and rarely loss of limb. Always discuss the risks and complications with your surgeon before any surgery.


How can I improve my chances of successful treatment?

By far, the most important controllable factor is smoking. Patients that smoke have higher rates of complications such as wound infections, blood clots, failure of treatment and ultimately a high chance of needing an amputation. Please discuss with your GP or surgeon about how you can stop smoking. Other factors that help include following instructions about weight-bearing, and maintaining a healthy and balanced diet.


How is the frame removed?

Once treatment is complete, the frame is removed under a general anaesthetic usually as a day case procedure.


What's it like living with a frame?

Due to its nature, the external fixator can be cumbersome and bulky. However, most patients quickly adapt to it and learn what best works for them. For more information, including advice about clothing, please visit


Where can I get more information about external fixations?

Please see our "Patient Leaflets" section for further information. Alternatively, you can visit reputable websites such NICE (National Institute for Health and Care Excellence), BOA (British Orthopaedic Association), or NHS Choices.


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