TECHNOLOGY UPDATE - PINLESS FIXATOR: REPLY.

Abstract

Dear Editor, I am thankful to Major Jaswinder Singh for reading the article with interest and sending his suggestions regarding application of pinless external fixator. All the details regarding selection of clips, application of clips and frame assembly are already included in the article. These practical points will help the surgeons in peripheral hospitals to master the technique of application. Regarding frame assembly, I do not agree with him as it is not possible to use two bars, as the system is designed for only one carbon fibre bar to be used in all dips. Carbon fibre rod should be of adequate length and diameter depending upon the age of the patient and length of the tibia. It remains an excellent ideal tool for emergency management of compound fracture shaft tibia and fibula in a peripheral setup especially in polytrauma patients. The main advantage of the pinless external fixator is to avoid further contamination of the medullary canal in compound fractures of the tibia as it uses trocar tipped clamps to grip the outer tibial cortex rather than pins to transfix it as seen in conventional external fixators [1]. This system can be applied without the aid of electrical equipment such as power drills for bone screw insertion or image intensifiers to facilitate bone alignment [2]. Evacuation to referral hospital is easier with the pinless fixator if considered necessary in polytrauma patients requiring superspecialist care.