Uniplanar External Fixation Hardware

This module allows medical officers and surgeons who are not orthopedic specialists to become confident and competent in irrigation and debridement, powered and manual drilling, positioning and correctly inserting Schanz screws, and constructing the uniplanar external fixator frame as part of external fixation procedures for open tibial shaft fractures performed in regions without specialist coverage. To maximize patient safety, this module teaches learners to use a powered drill to insert self-drilling Schanz screws through the near cortex and then manually advance Schanz screws into the far cortex to avoid plunging.

Table of Uniplanar External Fixation Sterile Prepping and Draping Supplies

#	Item	Quantity	Reference Image
1	Sponge stick	3
2	Gauze pad	3
3	Sterile preparation solution
4	Sterile drapes	3
5	Sterile clamps	3
6	Sterile towel	1
7	Sterile gauze roll	1 roll

Table of Uniplanar External Fixation Hardware, Equipment, and Supplies

#	Item	Quantity	Reference Image	Function
1	Irrigation solution	6L for a Gustilo Type II open tibial fracture and 9L for a Gustilo Type III open tibial fracture		Used for irrigation of open wounds
2	Syringe, 50 mL	1		Used for irrigation of open wounds
3	Bone reduction forceps	1		Used to manually reduce the fracture, compress the fragments together, and restore alignment
4	Bone holding forceps, medium size	1		Used to maintain reduction and is removed after the fracture is stabilized with the external fixator frame and acceptable alignment is confirmed
5	Scalpel blade and handle	1		Used to make a stab incision in the soft tissue at the insertion site for each Schanz screw; and to extend the wound to adequately expose the open fracture for direct visualization of the fracture (if required)
6	Dissecting scissors	1		Used to dissect through the soft tissue to expose the bone at the insertion site for each Schanz screw
7	Any powered surgical drill that is compatible with 4.5 or 5.0 mm diameter self-drilling Schanz screws can be used	1		Drives Schanz screw through the near cortex of the fracture fragment, also referred to as a "power drive"
8	Chuck key for surgical drill	1		Inserted into the circular opening in the drill chuck body and used to tighten or loosen the 3-jaw chuck over the Schanz screw
9	Self-drilling Schanz screws, 5.0 mm x 200 mm x 30 mm	4		Inserted into fracture fragments, also referred to as "pins" or "half-pins"
10	Drill sleeve for 4.5 mm or 5.0 mm Schanz screws	1		Used to protect the soft tissue when drilling the 2 "far" pins
11	Universal chuck with T-handle	1		Allows for manual advancement of the Schanz screw into the far cortex without exiting the far cortex
12	Chuck key for universal chuck with T-handle	1		Inserted into the circular opening in the chuck body and used to tighten or loosen the 3 jaws of the universal chuck with T-handle over the Schanz screw
13	Universal pin-to-rod clamp (single pin)	4		Combines a pin to the uniplanar rod
14	Uniplanar rod, 11 mm diameter x 300 mm length	1		Links pins with clamps; metal rod is cheaper but a carbon fiber rod is radiolucent which permits better visualization of the fracture on X-ray
15	11 mm spanner with T-handle	1		Assists in final tightening of the 4 pin-to-rod clamps

Instructional Videos for Universal Chuck with T-Handle

How To Install The Universal Chuck With T-Handle On A Schanz Screw

Manually rotate the chuck sleeve clockwise to tighten the 3-jaw chuck over the pin.

How To Use The Chuck Key To Install The Universal Chuck With T-Handle On A Schanz Screw

Insert the chuck key into the circular opening in the chuck body and manually rotate the chuck key clockwise to tighten the 3-jaw chuck over the pin.

How To Detach The Universal Chuck With T-Handle From A Schanz Screw

Manually rotate the chuck sleeve anticlockwise to loosen the 3-jaw chuck over the pin.

How To Use The Chuck Key To Detach The Universal Chuck With T-Handle From A Schanz Screw

Insert the chuck key into the circular opening in the chuck body and manually rotate the chuck key anticlockwise to loosen the 3-jaw chuck over the pin.

Acknowledgements

This work is funded by a grant from the Intuitive Foundation. Any research, findings, conclusions, or recommendations expressed in this work are those of the author(s), and not of the Intuitive Foundation.