Pinless external fixation. Indications and preliminary results in tibial shaft fractures.

A major drawback of conventional fixator systems is the penetration of the fixator pins into the medullary canal. The pins create a direct link between the medullary cavity and the outer environment. The new AO pinless fixator bypasses this disadvantage by clamping its trocar points onto the outer cortex without penetrating it. Thus, exposure and consequent contamination of the medullary cavity does not occur. The clinical use of this easily manageable fixator with no drilling requirement is for tibial fractures in which the general and local conditions are poor or the infrastructure of the clinic is inadequate for primary internal stabilization or both. All options for a later conversion to internal fixation remain open. For highly unstable tibial shaft fractures, the pinless fixator can be applied as an additional, minimally invasive, external, locked system to increase the stability of intramedullary nail fixation. The pinless external fixator can be combined favorably with the standard AO tubular system and is a valuable addition to the existing fixator systems.