Abstract
Dear Editor, This is with reference to the article published in MJAFI 2001;57: 234-6 by Lt Col S Chawla. The article has been written well and is very useful to junior surgeons in the peripheral hospitals. I would like to add a few practical aspects for the application of Pinless Fixator. 1. Selection of Clips : (a) A minimum of 4 clips (2 in each major fragment) should be used to achieve and maintain reduction. (b) Smallest available clip in each category should be used, which will accommodate the anatomy of the leg, for maximum stability of the frame. 2. Application of the Clips (a) Clips are placed according to the same principles (safe corridors) as for the external fixation to prevent neurovascular damage. (b) Asymmetrical clip should not be applied by rocking movement as done for symmetrical clip. It may be necessary to wiggle it slightly to ensure entry into the bone cortex. If rocking is done it will damage the anterior tibial crest because of the two prongs. 3. Frame Assembly Only one bar should be used on all clips. Use of a second bar on all clips may cause malalignment and/or clip slippage.
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