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Use of the dynamizable fixator 

Compression - Distraction

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1. Check that the fixator is in static phase by pushing along the long axis. If not, untighten the nuts on the D side, hold the fixator stable by a wrench on the C side, and tighten the nut D1 until you feel a good resistance (NOT TOO MUCH!!). 

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2. When the fixator is static, it shouldn't move along the long axis.

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3. Untighten the C1-C2 nuts, and bring them away from the C cylinder side. If you want to use the fixator for 
distraction, leave it as close as possible, with the C1-C2 
nuts far from the C cylinder as much as possible. Tighten 
C1 and C2 nuts together. Do the opposite if you want to 
use the fixator for compression. 

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4. Hold the fixator by the wrench at the C side of the cylinder, and rotating clockwise the couple C1-C2 you can get distraction, or you can get compression rotating 
counterclockwise. 

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5. Connect the fixator to the overlapped fracture by means of two pins.

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6. Rotate the C1-C2 couple holding the C cylinder side by    means of wrenches, distracting the fracture.

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7. Once the fracture is distracted, check the extensions of the clamps are securely tightened (1), and use the clamp to 
perform the final fracture reduction on the other planes.

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8. Once fracture realignment is achieved, stabilize it as required. To lock the fixator in position, tighten C1 against 
the C side of the cylinder, and then C2 against C1. When 
locked on both sides, the fixator will stay like you leave it. 

DYNAMIZATION 

 Once a bone callus developed, and dynamization can be 
 useful for its maturation, the fixator can afford for this.  
 Untighten the D1-D2 couple on the D side of the cylinder, 
 and move the D2 nut far from the D1 of the amount you 
want the fixator to allow for axial motion (typically, 2-3 mm). 
Then, untighten the C1-C2 couple, move it some mm far 
from the C side of the cylinder, and tighten it again. Rotate 
the C1-C2 couple counterclockwise, holding the C side of 
the fixator, until the D2 nut reaches the D1 nut. Lock both 
couples against both sides of the fixator. Once locked, the 
fixator will stay as you leave it (static or dynamic). 

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