External Fixation For Leg Fractures In Children

What you should know

  • External (eks-TER-nal) fixation (fik-SA-shun) of a leg fracture is surgery to repair your child's broken leg. A leg fracture is a break in the bones of his leg, such as the femur, tibia, fibula, and patella. The femur, or the thigh bone, is the longest bone in your child's body. The tibia, or shin bone, and the fibula, located behind the tibia, make up the lower leg. The leg bones help support your child's weight, and may break in different locations depending on the cause. Bad injuries caused by a fall, car accident, sports injury, or physical abuse may cause leg fractures. Your child may feel severe pain, have bruising and swelling, or have his bones sticking out through deep cuts on his skin.

  • External fixation is usually done if leg bones are broken at several places, or if bones are showing through deep cuts. It may be done if the tissues directly above the fracture has been badly damaged. It may also be done if the fractures are found at the ends of the leg bones. During this surgery, broken bones are aligned together by carefully pushing, pulling, and turning the broken leg. He will do this without making a cut on your child's skin. He may need to use drills, pins, rods, and screws to align the broken bones and hold them together. While being held steady, the chips of broken bone will grow together and get stronger. With an external fixation, your child's leg fracture may be treated and he may resume his usual activities.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.


  • There are always risks with surgery, such as bleeding and infection. Other parts of the leg, such as nerves, blood vessels, ligaments, muscles, and bones may be damaged. Your child's leg, foot, or toes may become stiff, swollen, painful, numb, or weak. Even after surgery, your child's broken leg may not heal quite right. His leg movements may not be the same as they were before. His legs may not grow evenly, causing one to be shorter than the other. Some nearby joints may get stiff and muscles may get weak. Your child may have trouble going back to his usual activities, including sports.

  • If left untreated, the pain and problems he may have with his leg may get worse. His broken leg may even grow out of shape and get crooked. His legs may also not grow together with each other, causing one leg to be shorter than the other. Call your caregiver if you are worried or have questions about your child's surgery, medicine, or care.

Getting Ready

The week before your child's surgery:

  • Tell your child's caregiver about any medicines your child is taking. Ask your child's caregiver about any medications your child should or should not take before the surgery.

  • Your child may need to have blood and urine tests, and chest and leg x-rays taken. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

  • Ask caregivers about directions for eating and drinking.

The day of your child's surgery:

  • Write down the correct date, time, and location of your surgery.

  • Caregivers will insert an intravenous tube (IV) into your child's vein. A vein in the arm is usually chosen. Through the IV tube, he may be given liquids and medicine.

  • An anesthesiologist may talk to you before your child's surgery. This caregiver may give your child medicine to make him sleepy before surgery.

  • You or a close family member will be asked to sign a legal piece of paper (consent form). It gives your child's caregiver permission to do the surgery. It also explains the problems that may happen, and your choices. Be sure all your questions have been answered before you sign this form.


What will happen:

  • Your child will be asked to change into a hospital gown. Your child may be given medicine in his IV to help him relax or make him drowsy. Your child will be taken on a stretcher to the room where the surgery will be done. Your child will lie on his back. He may get a general anesthesia to keep him completely asleep. His leg and hips will be cleaned and covered with clean sheets to keep the surgery area clean.

  • Your child's caregiver will align the broken bones together by carefully pushing, pulling, and turning the broken leg. He will do this without making a cut on your child's skin. He may use a fluoroscope (x-ray) to help him insert pins and correctly align the bones. Holes may be made on the bones by using a drill to insert screws and long metal pins. These pins will be placed through the intact parts of the bone on both sides of the fracture. These pins will stick out through your child's skin and other rods and devices will be attached to them. An x-ray may be done to see if the bones were set in the right way. Bandages will be wrapped around the areas where pins were inserted.

After surgery:

Your child is taken to a room where he can stay until he wakes up and is comfortable. Your child may be allowed to go home. If not, your child will be taken to a bed on one of the units in the hospital. Your child may be sleepy and have some pain after surgery. Your child should not get out of bed until caregivers say it is OK. Leave any bandages on your child until a caregiver takes them off.

Waiting area:

This is an area where family and friends can wait until your child is able to have visitors. Leave a phone number or other means of contact where you can be reached if you leave the area.

Contact a caregiver if

  • You cannot make it to your child's appointment on time.

  • Your child has a fever.

  • Your child has a skin infection or an infected wound near the injured leg.

  • You have questions or concerns about your child's surgery.

Seek Care Immediately if

  • Your child has a lot more pain or has trouble moving his leg or foot.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about External Fixation For Leg Fractures In Children (Precare)