An external fixator is a metal frame that holds bones in place. It has pins that go through the skin and into the bone. If the external fixator is used for limb lengthening, it has bars (called struts) that you turn to slowly lengthen the bone.

While the bone is healing, it is important that you clean the pins every day and do all of the exercises that your surgeon or physical therapist recommends. This will help your child get the best results from the surgery.

Follow the surgeon's or physical therapist's recommendations for:

• Bathing
• Exercises
• Cleaning the pins
• Turning the struts
• What activities are OK
• Medicines for pain
• Follow-up appointments

Do not use lotion, cream, or powder near the external fixator. 

To clean the pins:

• Wash your hands and put on gloves (the gloves do not need to be sterile).
• Remove any crusting around the pins:
  • Wrap sterile gauze soaked with saline around the pin site and let it sit for a few minutes. Use a separate piece of gauze for each pin site.
  • When the crusting is soft, remove it with a cotton swab (use a separate swab for each pin site) or tweezers that are cleaned with alcohol on sterile gauze before using and between each pin.
• Remove any clear or yellow drainage with a cotton swab (use a separate swab for each pin site) or tweezers that are cleaned with alcohol on sterile gauze before using and between each pin.
• Use a squeeze bottle to squirt saline on each pin and surrounding skin. Do not touch the tip of the bottle to the pins or skin.
• Dry around each pin using sterile gauze or cotton swabs. Use a clean gauze or swab for each pin.

Remember: You do not want the germs from one pin site getting into another because this can cause infection. So don't let anything that touches one pin site touch another. This includes gloves, gauze, tweezers, cotton swabs, and anything else that you use to touch or clean the pins.

• Your child has a fever.
• Your child has pain that gets worse.
• You notice signs of a pin site infection, such as redness, pain, warmth, swelling, or more drainage from any of the pin sites.

Your child has numbness, tingling, weakness, or loss of feeling in the involved arm or leg.

Do I need to adjust the external fixator? It depends on what the surgery was for. For example, if the surgery was done to lengthen an arm or a leg, you will turn the struts at home. Your surgeon will tell you if you need to adjust the external fixator at home.

Why do I need to clean the pins every day? The area around the pins can get infected easily. If this happens, your child will need to take antibiotics to cure the infection. Cleaning the pins every day as instructed by your surgeon will help prevent infection.

If the pins bleed a little, what should I do? It is expected that the pins will ooze a little bit of blood. You can apply gentle pressure with a sterile gauze pad until the bleeding stops. If the bleeding continues or gets worse, call your surgeon.

My child doesn't like to do the exercises. Are they necessary? The exercises are very important. The exercises keep the muscles strong. And the stretching helps the muscles, nerves, and ligaments keep up with the new bone growth.