Indications for External Skeletal Fixation Versus Internal Fixation

  • Günther Hierholzer
  • Thomas Rüedi
  • Martin Allgöwer
  • Joseph Schatzker


If we limit ourselves in the use of the external fixator to its strictest indications, then it is not in competition with the standard procedures of internal fixation. The external fixator should be viewed rather as an alternative to the methods of intramedullary nailing or plating, applicable whenever nailing or plating is considered too hazardous. We must remember, however, that bony union of fresh fractures usually takes longer with external fixation than with rigid internal fixation. Exceptions, of course, are the osteotomies carried out in metaphyseal areas of bone, or joint arthrodesis, where broad surfaces of cancellous and well-vascularized bone are brought under compression. These considerations pertain more to the tibia than to other bones that are protected by more circumferential muscle cover, so that both a delay of internal fixation and the different devices are better tolerated.


Internal Fixation External Fixator Septic Arthritis Extensive Soft Tissue Corrective Osteotomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Copyright information

© Springer-Verlag Berlin Heidelberg 1985

Authors and Affiliations

  • Günther Hierholzer
    • 1
  • Thomas Rüedi
    • 2
  • Martin Allgöwer
    • 3
  • Joseph Schatzker
    • 4
  1. 1.Unfallklinik Duisburg-BuchholzDuisburg 28Germany
  2. 2.Chirurgischen KlinikRätisches Kantons- und RegionalspitalChurSwitzerland
  3. 3.AO InternationalBernSwitzerland
  4. 4.TorontoCanada

Personalised recommendations