 1. Application of the SK™ fixator begins with placement of a single pin into the major proximal fragment and a single pin into the major distal fragment. Traditionally, these first pins have been the most proximal and distal pins of the frame, but location can be varied. A connecting rod is secured to the first two pins using SK™ single clamps. Empty clamps to accommodate the anticipated number of additional fixation pins can be pre-placed onto the rod or added later. 2. A release incision at least 1cm in length is made at each pin placement site. An empty clamp is positioned over the pin placement site. After correct orientation of the clamp is achieved, it is maintained by tightening the secondary clamp bolt. A drill sleeve is placed through the pin-gripping bolt of the clamp and gently tightened (do not crush hollow sleeve) to protect the soft tissues as the bone is pre-drilled in preparation for pin placement. The sleeve is removed and the fixation pin is applied through the primary clamp bolt using a Jacobs hand chuck or low RPM power insertion technique. |
 
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| 3. Fixation clamps are secured by alternate
tightening of the secondary bolt and the nut on the primary bolt.
Tightening torque has the potential
to cause loss of fracture reduction or alignment. This potentially
disruptive force can be neutralized during clamp tightening with use
of the “two-wrench technique.” An open-end wrench placed
on the flat surfaces of the head of the primary bolt (figure 3), or
on the flats of the clamp body (figure 3 - inset), is used to neutralize
torque force while a second wrench is used to tighten the clamp. Alignment
should be re-checked with each pin application, and all clamps should
be re-checked for tightness at completion of surgery.
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