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Technique for reduction and stabilization of a diapyseal tibia fracture

By a dynamizable fixator

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1. Diaphyseal tibia fracture.

2. Select the fixator of the proper size. It should span the whole length of the tibia. 

3. Check that the fixator is in the locked position,  i.e. not dynamized. You can use it for intraop 
distraction only in this state. 

4. Connect the fixator to each bone stump by  means of one threaded pin each, as close as 
possible to their proximal and distal extremity, 
respectively. Use clamps with the extension, in 
order to be able to direct the pins in every plane. 

5. Distract the fracture by lengthening the  fixator. Turn the coupled nuts on the C part of 
the fixator by a wrench, holding the extremity of 
the fixator by a second wrench. 

6. Proceed up to when the fragments are  distracted so that they are no more 
superimposed. The fixator will lenghten during the procedure. 

7. Perform the maneuvers required to correct the  fragment axis and position. The clamp with 
extension will allow adjustments on every plane. 

8. Achieve the correct fracture reduction BEFORE adding any further pin. 

9. When you are satisfied with the reduction, add at least one pin to each fragment. For the 
intermediate pins it’s not usually necessary to 
use extensions, but remember the pin will stay 
perpendicular to the fixator’s axis. 

10. If you need to have inclined pins due to the  fracture features, it’s possible to use all the 
clamps with extensions, in order to hold them at the required angle.

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