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Temporary external fixation across the ankle after tibial nailing
Gregory M Georgiadis1, Steven P Haman
1Department of Orthopaedic Surgery, Medical College of Ohio, Toledo, OH 43614-5807, USA. ggeorgiadis@mco.edu
Journal of Orthopaedic Trauma
|March 11, 2005
Summary
This study presents a technique combining external fixation and intramedullary tibial nailing for severe open ankle fractures. This method aids soft tissue healing and prevents foot deformities during recovery.
Area of Science:
- Orthopedic Surgery
- Trauma Management
- Reconstructive Surgery
Background:
- Open fractures of the tibia with severe soft-tissue trauma present complex treatment challenges.
- Managing associated foot and ankle injuries requires careful consideration of wound healing and joint positioning.
Observation:
- A temporary spanning external fixation device applied across the ankle can be used with intramedullary tibial nailing.
- This combined approach facilitates wound access and maintains the foot and ankle in a neutral, plantigrade position, preventing equinus contracture.
Findings:
- The external fixator provides rigid immobilization for 3 to 6 weeks, protecting skin grafts and muscle flaps from shear stress and muscle motion.
- This period of stability is crucial for soft tissue healing in complex fracture scenarios.
Implications:
- This technique offers a viable solution for selected patients with severe open tibial fractures and extensive soft tissue damage.
- It optimizes conditions for wound healing and subsequent functional recovery of the ankle and foot.