PROCEDURE

1. Assess pins, pin sites, and stability of frame every 4

hours. Prevents complications and pin site infections.
a. Assess pins for breakage, bending, or shifting. Pins

should be immobile.

b. Assess pin sites for signs of infection (redness,

edema, heat, tenderness, drainage). Pins sites should
be clean and dry.

2. Assess neurovascular status of affected limb every 4

hours (capillary refill, color, temperature, movement,
feeling). Children with external fixation devices usually
have extensive soft tissue, nerve, and vessel damage.

3. Provide teaching to parent and child before discharge.

a. Explain how to perform neurovascular checks, how to

assess the pins sites, and when to call the physician.

b. Demonstrate pin care and have the provider give a

return demonstration. Ensures that caregiver using
aseptic technique.

c. Reinforce instructions regarding activity level and

weight bearing.

d. Explain that fixation device should not be used as a

handle.

e. Demonstrate range of motion exercises if appropriate

and have child and caregiver return demonstration.
Ensures appropriate exercises being performed.

f. Instruct child and caregiver to elevate the extremity

if edema occurs in the affected limb. Improves
venous return.

g. Teach appropriate use of assistive devices as neces-

sary. Prevents falls; inappropriate use of device could
cause accidents.

DOCUMENTATION

1. Neurovascular status and pin site condition.
2. Condition/status of fixation device.
3. Teaching done and parent/child comprehension. Return

demonstrations given.

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Copyright © 2007 by Thomson Delmar Learning, a division of Thomson Learning, Inc. All rights reserved.

SKILL 32

SKILL 32

Care of the Child in an External Fixation
Device