Adjusting the struts
You may be required to assist in the correction process by making daily strut adjustments at home. Adjustments generally are painless. An adjustment plan will be prescribed specifically for you and it is imperative that you follow the schedule closely. Our staff will make sure that you understand how and when to make adjustments. If you experience mechanical failure of the frame such as inability to adjust a strut, a broken pin, or loose parts, call the office to receive further instructions.
You will have to primarily sleep on your back, and you may require more rest than usual due to the increased energy demands of the healing process. When you are sleeping or resting, keep the extremity elevated to decrease swelling and increase comfort. You may want to sleep with the frame covered (see pictures at the bottom of this page) to avoid dirtying or damaging your linens.
Standing and sitting
Always use caution to avoid falls, and be very careful when sitting down or standing up. To stand up, move forward to the edge of the chair and push off of the seat with your hands. To sit down, back up to the edge of the chair and use your hands to lower your body into position. It may be helpful to place one of your hands on your crutch while raising your body to a standing position or lowering your body into a chair.
Using a toilet
Use similar caution for sitting and standing when getting on and off a toilet. You may consider using an elevated toilet seat or placing a handrail in the restroom. Make sure someone is nearby to help you if necessary. Personal hygiene and hand washing is extremely important.
Most patients are allowed to shower after about 3 weeks. You may consider placing a rubber mat in the tub, utilizing a shower chair, utilizing a handheld showering device, or installing handrails for safety. Cleaning the pin sites with antibacterial soap while in the shower is simple and effective. Allow soap and water to run down the extremity while washing the area gently. Rinse and dry the external fixator and the extremity thoroughly. It may be helpful to use a hair dryer on the cool setting. Once the pin sites are clean and dry, place gauze dressings on the pin sites as usual.
It is important to lead as normal a life as possible when wearing the frame and staying active is important. Walking stimulates the bone to heal, desensitizes the area, helps avoid joint contractures, and may help avoid blood clots. Check with the doctor for restrictions on the amount of weight you are allowed to put on your extremity. Swimming is allowed in chlorinated pools. Swimming in hot tubs or natural waters (lakes, rivers, oceans) should be avoided because of possible contamination leading to infection. After swimming, immediately shower with soap to clean your frame. Once the pin sites are clean and dry, place gauze dressings on the pin sites as usual.
Some patients may require physical therapy. Therapy can help maintain range of motion, promote muscle strengthening, and prevent contractures. Sometimes therapy begins in the hospital and continues after you are discharged. The most important factor in your success is home exercises on your own regardless of whether you do physical therapy.
After frame removal
After your frame is removed, you may have to wear a cast or a brace on the limb for a period of time. This will give your bones a little longer to heal and strengthen. You will likely continue your exercises and increase your activity level. Motion and weight on your extremity promotes bone remodeling. A maintenance program of flexibility and strengthening is important for your long-term health. Some options include yoga, pilates, strength-training, spin, or other activities which may need to be individualized for your condition. Biking, swimming, and the use of cardiovascular machines such as an elliptical trainer, stairmaster, or a stationary bike may be beneficial.
You may need to make clothing modifications and adjustments to your wardrobe. www.ILIZAROV.org.uk. is a public website with great ideas for clothing, shoe modifications, exercises, etc.
If the external fixator is on your leg:
- Snap-on athletic pants or shorts may be easiest. Some pants snap all the way up to the waistband.
- Pants can be altered by cutting the inside seam up to the crotch, or the outside seam up to the waistband, and inserting triangular pieces of fabric to widen the area.
- During warm weather, shorts or cut off pants may be preferred.
- Dresses or skirts may be a good option.
- Underwear can be altered by cutting the side seam and securing it with hooks, loops, or velcro®.
- Underwear that ties on both sides at the hip can be used.
If the external fixator is on your arm:
- Shirts can be altered by cutting the inside seam of the arm and inserting triangular pieces of fabric to widen the area.
- Secure the extra fabric inserts with hooks and loops or with buttons.
- Use a shawl or cape to keep warm during colder weather.
- Cut the cuff off sweaters and shirts to enable the sleeve to fit over your arm.
If the external fixator is on your foot:
- You may need to modify a pair of shoes.
- Local orthotics and prosthetics shops can help you fit a sole to the bottom of the fixator.
- A frame cover can help keep your foot warm.
It may be easier to keep the external fixator and your incisions clean if you keep them covered. There are many different options to make a cover. Some people customize their own cover out of blue jeans or a pillow case. You may want to have a cover to wear during the day and then a second cover you keep clean only to sleep in at night so your linens stay clean. Below are some examples.