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What’s a fixer?

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Fixators provide support and stability to a part of the body in motion. Internal fixation uses screws and devices to support bone healing, while external fixators provide support to broken bones. Muscles can also act as fixators. Simple fractures can be healed with a cast, but complicated fractures require internal or external bone fixation. Orthopedic surgeons place both types of fixators, with internal fixators often left in place permanently. External fixators are removed once the bone has finished healing.

In medicine, a fixator is a device that provides support and stability to a particular part of the body when in motion. Fixators can be internal or external. Internal fixation uses screws and other small devices to support bone healing. An external fixator is a device used to provide stability and support to broken bones. They are used in cases where a cast does not provide sufficient support as the bone heals.

This term is also used in anatomy, where a similar principle applies. Many muscles in the body can act as fixators, preventing unnecessary movement of muscles when other parts of the body move. When someone performs a bicep curl, for example, the bicep muscle is the primary motor regulating the action, while muscles in the back, abdomen, shoulders and wrist act as fixators, supporting the body during the movement.

Most simple fractures can be healed with the use of a cast, which immobilizes the broken bone and provides the support it needs to heal properly. Internal or external bone fixation is used as a treatment for complicated fractures that cannot heal through the use of a cast. These devices are fitted during a surgical procedure that fixes the broken bones in place before applying an external or internal fixator.

Internal bone fixation is done via a procedure called open reduction internal fixation. For this procedure, screws, plates, or metal rods are used to hold the broken bones in place so they can heal properly. Severe fractures may require the use of an intermedullary rod, a long, thin metal rod that is inserted into a long bone such as a tibia or femur. The rod helps promote healing by sharing the weight-bearing load of the bone as it heals.

External bone fixation tends to be used as a temporary treatment of the fracture or can be used in cases where internal fixation is not possible. To fit an external fixation device, holes are first drilled into the undamaged bone surrounding the fracture location. The metal pins are inserted into the holes and the external fixation device is then fitted to the pins and adjusted to provide the necessary support for the fractured bone. Most of the fixation device is on the outside of the body, with only the metal pins contacting the bone.

Placement of both types of fixator is done by an orthopedic surgeon, with the patient under general anesthesia. Internal fixators, especially intermedullary rods, are often left in place permanently to provide support to a bone that may have been weakened by a fracture. The external fixators are removed once the bone has finished healing; depending on the severity of the fracture, it will take at least six weeks and may take several months.

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