Technique for reduction and stabilizationof a distal tibia fracture
By hybrid frame
1. Distal tibia fracture.
2. Insert a K wire parallel to the distal articular surface, and connect it to a ring.
3. Insert a K wire parallel to the proximal articular surface, and connect it with a 3/4 ring with the opening oriented caudally.
4. Connect the rings with threaded bars and hemispherical nuts and washers, taking care the length of the bars is enough to distract the fracture.
5. Distract the fracture by lengthening the threaded bars.
Use two bars for standard distraction, three bars if the tension makes the fragment to incline.
6. Once the fracture is distracted, correct traslational and rotational deformities to achieve the best possible fracture reduction and alignment.
7. Connect a rail of adequate length to the distal ring.
8. Stabilize the fracture by a pin connected to the rail.
9. Add a K wire on the distal ring and a pin on the rail.
10. Complete the fracture stabilization adding one pin on the distal fragment and one on the proximal fragment.
11. In very unstable fractures or very exuberant dogs a further pin can be added to the proximal ring, and the proximal circular component left for at least some weeks.
12. If you trust the fracture reduction and the patient, the proximal part can be removed and just the hybrid construct left.