External Fixators

What is an external fixator?

An external fixator is a stabilizing frame to hold the broken bones in proper position. In an external fixator, metal pins or screws are placed into the bone through small incisions into the skin and muscle. The pins and screws are attached to a bar outside the skin.

Sometimes day to day activities can seem more challenging when you have an external fixator. Here are some practical tips that might help to make some of these tasks seem a little bit easier.

Try to lead as normal a life as possible

Seeing friends and family, getting out, and doing things you enjoy are all important for someone’s well-being during treatment and recovery. 

It may be useful to think carefully about what you can do and plan ahead when visiting places, for example, find out where the disabled access is, if the toilets are accessible, and look up transport to get you there and back.


It takes a lot more effort to get around with a frame and with a walking aid if you need to use one. You will need to plan your day and week thinking about what is most important and when you have the most energy or are the most tired. Making lists may help you to plan and prioritise your day.

It may be easier to sit to do household tasks such as preparing meals, getting dressed or sorting laundry. Online shopping and home delivery, and pre-prepared meals or ingredients can be helpful.

It may be worth considering hiring a wheelchair if you find walking very tiring but want to visit shops and other facilities or events.

Carrying items

Using an over the shoulder or cross body bag or a rucksack might be useful for carrying a drink bottle and other items. Some people attach a shopping bag onto walking frame handles. A thermos flask is useful for hot drinks or soups and can be placed in a bag to transport. A kitchen trolley may be useful to move whole meals from your kitchen work surface to table.


It is ok to shower your limb with the frame as long as none of your pin sites are infected. Don’t submerge the frame in water and avoid perfumed soaps or shower gels (baby shampoos are best). You need to thoroughly dry your frame with a fresh towel and clean all of your pin-sites after every shower.

Most people find that they need to sit to shower. If your shower is large enough you could fit a shower chair. If you have a bath you can sit over the bath using a bath board but you need to be careful that the frame doesn’t damage the bath enamel. Some people put a towel and/or a non-slip bath mat over the surface of the bath to protect it from damage.


Using extra pillows may be useful to position your limb and if you have a frame on your lower limb you may like to use a pillow or a foam wedge to stop your other leg rubbing against the frame. Some people use a bed cradle or frame and a mattress protector or a sheepskin to protect their sheets and mattress from the frame. A loosely filled bean bag is very good as it moulds to the shape of your body and the frame.


You may need to adapt the clothes you wear to fit over the rings of the frame. Some tracksuits have zips or poppers on the outer legs which can fit over the frame. You may find you need a size larger. Some patients prefer to wear shorts or skirts. Other patients adapt their trousers by adding extra material or Velcro fasteners to the outer edge of the trouser leg.


Having a frame should not stop you having normal relationships. You may want to cover the frame to protect your partner’s skin and may also need to consider different positions depending on what you feel able to manage and the type of frame and rings that you have.

Returning to driving

Whether you can return to driving depends on your frame, your strength, your ability to weight bear and the amount you can move the rest of your limb.

For lower limb frames, the type and make of your car, and the space within the foot well and around the pedals will also make a difference. Some people can drive automatic cars but not manual. Please discuss driving with your consultant and your treating team.It is also necessary to inform the DVLA and your insurance company.

It should be possible to get into a car as a passenger, and people may find the front passenger seat more comfortable and easier to get into.

Swimming and hydrotherapy

Hydrotherapy is ok as long as all your pin-sites are healthy. You must shower before entering the pool and clean all pin sites afterwards.

Swimming in public pools, in the sea or in rivers or lakes should be avoided as any dirt or sand will increase your risk of infection.

Going on holiday

Many people find it easier to go on holiday within the UK while they are having treatment.

It is important to think about how travelling could affect you. Ask yourself if you will be able to sit comfortably and if you can cope with the time the journey will take.

If you want to fly, you will need to discuss this with your consultant or clinical nurse specialist. You will also need to think about how you will access medical services if you need them while you are away, and how to fit your trip around your clinic appointments. Finally you will need to take out appropriate travel insurance.

Do not sunbathe as the metal of the frame can conduct the heat and get hot, and your skin may be more vulnerable to the sun if it has been injured in the past.

Returning to work

Returning to work depends on the type of work you do and the duties involved.

Some people can easily adapt their work duties, hours and environment and can manage the journey to their workplace OK.

Others, for example those working in the food industry may face restrictions due to requirements such as health and safety laws.

Returning to work should be discussed with your employer and occupational health, if applicable. The Citizens Advice Bureau (CAB) or a Disability Employment Adviser (DEA) based in a Job Centres can also give you information and support.

Thanks to St Georges' University Hospitals NHS Foundation Trust, Major Trauma Therapy Team, @STGTraumaPTOT for this information