Technique for reduction and stabilizationof a distal tibia fracture
By hybrid frame
1. Proximal tibia fracture.
2. Insert a K wire parallel to each articular surface, and connect them to half rings.
3. Connect the half rings with threaded bars and hemispherical nuts and washers.
4. Distract the circular frame, and check the fracture overlap is reduced.
5. Check for fracture reduction, and correct any residual angular and torsional deformity. DO NOT any further stabilizing device before the fracture reduction is achieved.
6. Connect a linear rail to the proximal ring in cranio-medial position to the tibia.
7. Stabilize the fracture by a threaded pin in a cranio-medial direction in the distal fracture segment connected to the rail in the distal slot of the rail. Careful: NOT at the extremity of the slot, allowing for further adjustments.
8. Insert a second pin with cranio-medial direction in the proximal fracture segment.
8. Insert a second pin with cranio-medial direction in the proximal fracture segment.
9. Stabilize the fracture by threaded pins inserted in each fracture segment as required to stabilize it. The pins in craniolateral direction should be put cranial enough not to transfix the cranial tibial muscle.
10. Remove the threaded bars and distal ring, leaving the hybrid construct. Consider using the sail-shaped stabilizing construct when required.