External Fixation Tibia Fracture

External Fixation Tibia Fracture

Benjamin Shore, MD, MPH, FRCSC

Patient Positioning (Figure 25-12)

  • Supine on the radiolucent table.

    • Bump underneath ipsilateral buttocks to prevent external rotation of operative leg

    • Avoid malrotation by placing the hip and the knee directly pointing to the ceiling. Look longitudinally from the foot and the limb position of the anterior hip and anterior knee should match and make sense. Significant internal or external rotation of the foot and the distal fracture should be a cause of concern and reevaluation.

  • Complete fluoroscopic AP and lateral views at the knee, fracture, and ankle to assure ability to visualize tibia completely and obtain provisional reduction

Figure 25-11 ▪ Basic circular ring set.

Figure 25-12 ▪ Intraoperative set-up for placement of external fixator. Note the fluoroscopic machine comes from the lateral side.

Surgical Approaches

  • Generally, in open fractures where the fracture ends need to be exposed and cleaned, the use of a uniplanar standard external fixator is easiest as the fracture can be manually reduced and held with reduction clamp, while the frame is placed and tightened.

  • In cases of closed injuries where reduction is unable to be maintained/obtained, then use of a circular fixator (Taylor spatial frame) is preferable as a preliminary reduction and gradual reduction can be done by using the program with strut lengthening or shortening to achieve anatomic reduction safely over time.

Reduction and Fixation Techniques

Feb 5, 2020 | Posted by in ORTHOPEDIC | Comments Off on External Fixation Tibia Fracture
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