Adjusting the Strut Lengths
The type of external fixator that you have attached to your leg or arm is adjustable. The bone is connected to the rings around your limb. When the struts make the rings move, the bone moves too. This allows gradual movement of the bones over time to correct a deformity or to bring the edges of a fracture together again.
You will be given a prescription that consists of a series of numbers. These correspond to the lengths of the struts on the frame. The six struts have their own coloured ring as well as a number to prevent mistakes being made. The struts have two markers that show the length of the strut. There is an orange line which is adjusted by your surgeon. There is a green line that can be adjusted by you. The green line can be moved by rotating the black plastic ring at the zero end of the scale on the strut. The adjustment ring does not move unless you pull it away from the scale to release it. It can then be rotated.
When the adjustment ring rotates, it makes a clicking noise. The number of clicks can be counted and is listed on the prescription that you are given. However, it is more reliable to check that the green line is indicating the right number on the scale. By rotating one way, the strut length is shortened and by rotating the other way, the strut length is increased. You should check that the green line is moving in the right direction after adjustment.
You should perform your adjustments on a daily basis. These adjustments may be timed for several times in the day or you may get a single line of adjustments for the whole day.
If you only have a single line of adjustments, and if you can remember, it is helpful to turn struts 1 and 2 in the morning, struts 3 and 4 in the afternoon, and struts 5 and 6 in the evening. By spreading them out, it will result in less discomfort and prevent any quick changes in the bone position that might threaten bone growth.
Sometimes moving the wheel is difficult. If this occurs, please let us know.
It is common to feel some aching in your leg after you have performed the strut adjustments. Unless this is severe, it should be alleviated by taking some painkillers. However, do not take anti-inflammatory tablets like ibuprofen or diclofenac (voltarol) or naproxen, as these interfere with bone formation.
You will be seen in the clinic on a weekly basis while you are performing adjustments to ensure that everything is moving in the right direction.
If you have any concerns, then please contact us and we will try to see you in the clinic in the same week to deal with any problems.
It is really important that you have regular physiotherapy or are performing regular exercises to stretch out the muscles in your leg. If you don’t perform stretching exercises, then the muscle can lag behind the stretched bone, and this results in bending of the knee or ankle, which can be very difficult to correct afterwards.