Executive Editor: James Hunter

General Editor: Fergal Monsell

Authors: Andrew Howard, Peter Schmittenbecher, Theddy Slongo

Pediatric forearm shaft 22u-D, 21r-E/M - External fixation

Aftercare following external fixation

Pin-site care

There is no universally agreed protocol for pin site care.

The following points are however recommended:

Pin site infection
Initial management is with oral anti-staphylococcal antibiotics.

In case of pin loosening or unresponsive pin site infection, the following steps should be taken:

Internal fixation following an infected external fixator pin has a high risk of infection and should be avoided unless no reasonable alternative is available.

See also the additional material on postoperative infection .

Compartment syndrome

See the additional material on compartment syndrome .


Elevation is useful in the initial stages. A sling is helpful if fixator configuration allows its application.

The patient should be encouraged to move the wrist and elbow, within the limits of comfort.


The patient should be seen 7-10 days after surgery for a wound check.

X-rays are taken to check stability and alignment.

See also the additional material on healing times .




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v1.0 2018-11-28