This will be a prospective, randomized, within-subject, single-blind trial to be conducted at Temple University Hospital. Patients who are determined to require an external fixation procedure of the lower extremities due to fracture or dislocation will be considered for enrollment according to the above inclusion criteria. Standard of care for treatment of their fractures will be provided. Once patients have provided informed consent for enrollment in the study, their pins will be randomized in a paired design according to a computer generated randomization schedule. There will be two types of pins, pre-drilled and non pre-drilled. A standard external fixation device requires two pins on each side of the fracture. Each pair of pins will have one each of pre-drilled and not pre-drilled pins, according to the randomization schedule. Therefore, each patient will have two pre-drilled pins and two pins inserted without pre-drilling. Some surgeons may prefer three pins on each side of the fracture/dislocation that is to be immobilized. We will have a randomization protocol for these situations as well.