How many methods of external fixation are there? How to choose?

  Common external fixation methods include small splints, plaster bandages, abduction frames, continuous traction, and needle-piercing external fixators. Small splint fixation is commonly used for fractures of the humerus, ulnar radius, tibiofibula, distal radius and ankle. Some intra-articular fractures, fractures near the joint and femur fractures are not suitable for small splint fixation. For bone and joint injuries and post-operative external fixation of bone and joint, plaster bandages are mostly used.  For serious shoulder and elbow joint trauma, as well as after some upper limb orthopedic surgery, it is necessary to apply abduction frame fixation.  Continuous traction can be divided into manual traction, skin traction and skeletal traction. Manual traction is mostly used for the correction of fracture displacement and joint dislocation, while skin traction has less traction force and is suitable for traction treatment of pediatric femur fracture, traction of unstable humerus fracture and auxiliary traction of adult lower limb fracture and auxiliary traction of lower limb skeletal traction. If greater traction force and longer traction time are needed, skeletal traction can be used, and it is divided into different parts of bone traction according to different indications.  (1) ulnar hawk’s-beak traction: it is suitable for those who have displaced humeral neck, stem, supracondylar and intercondylar comminuted fractures and serious local swelling, which cannot be immediately reset and fixed, as well as those who have old shoulder dislocations that will be reset by manipulation.  (2) Distal radial and ulnar traction: for open radial and ulnar fractures and old posterior dislocation of the elbow joint.  (3) Supracondylar femoral traction: for displaced femoral fractures, displaced pelvic ring fractures, central dislocation of the hip joint and old posterior dislocation of the hip joint.  (4) Tibial tuberosity traction: the same indications.  (5) Distal tibiofibular traction: for open tibiofibular fractures or knee fractures where tibial tuberosity traction is not appropriate.  Heel traction: for the early treatment of unstable tibiofibular fractures, certain heel fractures and mild contracture deformities of the hip and knee joints.  (7) Traction on the proximal ends of metatarsals 1-4: this technique is mostly used with the heel traction pin to co-assemble a bone external fixation frame for traction or fixation to treat compression fractures of the cuneiform and navicular bones.  (8) Cranial traction: It is suitable for cervical spine fractures and dislocations, especially for fractures and dislocations with spinal cord injury.  (9) Head ring traction: applicable to the correction of spinal fractures or dislocations.  In addition, there are still some methods of traction using traction belt: (1) Occipital and maxillary belt traction: applicable to mild cervical fracture or dislocation, cervical disc herniation and radicular cervical spondylosis.  (2) Pelvic belt traction: for lumbar disc herniation.  (3) pelvic suspension traction: for pelvic fractures with obvious separation and displacement or pelvic ring fractures with upward displacement and separation and displacement.  (4) Thoracolumbar suspension belt traction technique: applicable to compression fractures of thoracolumbar vertebrae.  For open fractures or infected fractures, fracture nonunion, limb lengthening, multi-segment fractures of femur or tibia, unstable comminuted fractures, joint fusion, external bone penetration pin external fixation frame can be applied.