External Fixation for Pedicle-Flap Immobilization

Suspension of Leg via a Single Tibial Pin Provides Postoperative Elevation and Pressure Off-loading for Lower Extremity Free Flaps

“…Much of the literature describes modifications of the Hoffman apparatus and other external fixation devices utilizing multiple pins. 1–4 We present a method of lower extremity elevation utilizing a single tibial pin outside the zone of injury.…”

Review: Innovative Techniques in Preventing and Salvaging Neurovascular Pedicle Flaps in Reconstructive Foot and Ankle Surgery

“…Several publications have described the use of various external fixation devices to immobilize the foot and ankle and offload compromised areas of the foot, ankle, and/or leg. [24][25][26][27] Commonly used for ease of application is a hybrid "kickstand" external fixator to provide immobilization, complete pressure relief, elevation of the lower limb, and the ability to observe repeatedly the flap while allowing for easy dressing changes. 28 This external frame is very useful in patients who do not require concomitant osseous procedures, are not obese, or do not require weight sharing across the involved extremity.…”

Groin Flap Immobilization by Axillary Brachial Plexus Block Anesthesia

“…Secure bandaging has resulted in cutaneous lesions. Drabyn et al 15 and Nappi and Drabyn 16 have reported the use of the Hoffman apparatus for immobilization of pedicle flaps and several advantages, such as comfort, avoidance of hot, foul-smelling dressing, ease of wound tension or torsion observation. Our technique has the same advantages and additional superiority, with no prerequisite of an empty stomach, offering a wide range of application, especially in emergency conditions, and reduced general anesthesia period and postoperative need of analgesia.…”