Double Squeeze Reduction Clamp Technique for Fracture Stabilization: A Case Report

The double squeeze technique for fracture stabilization is a technique in which the surgeon uses a second reduction clamp to hold and stabilize a smaller reduction clamp that reduces a fracture or plate yet is too small to hold by itself. This technique greatly assists anatomic fracture reduction and stabilization and allows the surgeon to complete the operation when there is limited reduction instrumentation available, or the surgeon needs more excursion on a small clamp holding a fracture and does not want to change instruments and possibly lose a reduction. We present a case of the double squeeze clamp technique, which to our knowledge has not been reported, to facilitate limited open reduction percutaneous plate stabilization in a distal tibia fracture.

This case report presents an 18-year-old male with a closed, oblique, displaced right distal tibia fracture following a crush injury to the extremity with a tree while using a chainsaw. He was initially seen in the emergency room and was discharged home in a splint to follow-up with the orthopedic surgeon on call. The family requested follow-up with our practice 3 days later and requested surgery at their rural local hospital secondary to insurance reasons. Patient requested plate fixation to treat his fracture. Due to limited reduction instrumentation in the facility, a double squeeze reduction clamp technique using a pointed reduction clamp on a serrated reduction clamp that was too small to hold the plate on the reduced fracture accomplished stabilization of the plate on the fracture while screws were placed.

The double squeeze reduction clamp technique using one reduction clamp on a smaller reduction clamp greatly increases the ability to successfully reduce and stabilize multiple variations of different fractures whether secondary to differences in sizes of the bones, different types of bones, or in our case limited fracture reduction tools available.