A Simple Technique of Outpatient Clinic Removal of External Fixators Using a Topical Cryorefrigerant Anesthetic

Abstract

The purpose of our study was to assess patient satisfaction with office removal of external fixators using a topical cryorefrigerant anesthetic spray. Twenty-two subjects were selected in a non-randomized fashion and twenty-one subjects completed the study. After IRB approval, a prospective study was performed of patients presenting to the orthopaedic clinic for removal of an external fixator. Informed consent was obtained and patients completed a visual analogue score and simple questionnaire which included anticipated pain both before removal, pain experienced after fixator removal, and overall patient satisfaction. A topical anesthetic spray was used at the pin-skin junction prior to removal of the half-pins. There were 17 males and 4 females, average age 38.3 years, whose fixators had been in place for 6.6 weeks (range, 3.5 to 20 weeks) for the following injuries: distal radius fractures (11), pelvic ring injuries (4), tibial plateau fractures (2), pilon fracture (1), tibia-fibula fracture (1), elbow fracture (1), and mid-foot injury (1). The average time it took to remove the fixator was 7.7 minutes. Twenty-nine percent of patients anticipated no pain at all from fixator removal. The average pain score after fixator removal was 42 % of maximum. Thirty-three percent had no pain from fixator removal. Eighty-nine percent of patients were satisfied with the procedure. External fixators can be comfortably and safely removed in the outpatient clinic using a topical cryorefrigerant anesthetic spray.