Most lower limb fractures in adults and children can be treated with closed reduction and cast fixation. However, these types of fractures usually require surgical stabilization: compound, displaced, open, in patients with multiple injuries, associated with neurovascular injury or with significant soft tissue injury, and comminuted shaft fractures. For these complex fractures, internal or external fixation methods are available. Internal fixation refers to fixation of screws and/or plates inside the body to support the bone directly and enable or facilitate healing. External fixation is indicated when internal fixation is contraindicated and for treatment of open fractures, malunions or nonunions, or as a temporary solution. External fixators are also used in bone deformity correction and in limb-lengthening procedures.