Dynastab S: A new concept for high energy fractures of the distal tibia

Background. High energy fractures of the distal tibia ("pylon fractures") usually result in severe reduction of the range of motion of the superior ankle joint. If there is severe soft tissue trauma coexisting with the fractures, the possibilities for surgical treatment are limited. Our study examined the suitability of the DYNASTAB S external fixator (for ankle joint stabilization). Material and methods. We studied 25 adult patients (15 men, 10 women), treated from April 2001 to March 2003, to whom the DYNASTAB-S stabilizer was applied for an average of 10.5 weeks. Results. In all patients bone union was achieved, with a good range of motion in the talo-crural joint. All patients tolerated the applied treatment well. The average hospital stay was 9 days. There were 2 cases of transient inflammatory reaction of the skin around the screws, and 1 case of algodystrophy syndrome, which resolved after physical treatment combined with pharmacotherapy. Conclusions. The Dynastab S external fixator is very successful in the treatment of fractures with poor prognosis in traditional methods of conservative and surgical treatment, providing bone union and good functional efficiency of the superior ankle joint. The use of the mechanical joint imitating the movement of the injured ankle joint allows for early joint rehabilitation without loss of stability of the fracture. Adaptation of the device to the operated limb is excellent. The Dynastab S external fixator can be recommended for wider use in the treatment of pylon fractures.