FRACTURE: Interval fixation of fracture using external fixation
This is a case of a 45 yr old
female who had suffered a fracture in both bones left leg due to run over by a
vehicle. The patient leg was swollen with bad bruising of skin over the inner
aspect of the leg. X rays showed badly comminuted fracture tibia and fracture
fibula. The tibia could not be fixed in the first sitting due to bad overlying
skin condition. Hence the plan for interval plating of tibia was done. The
patient was taken to operation theatre and fibula was plated first to gin
length and alignment of the limb. The plate using in fibula was a strong
locking plate to bear the stress of fixation. The tibia was stabilized using an
ankle spanning external fixator. After 3 weeks, the swelling markedly
decreased. The bruising also decreased. The external fixator was removed and
the patient was given a back slab plaster to let the pin tracts heal. After one
week, the tibia was plated using per cutaneous minimally invasive technique and
no bone grafting was done. The ankle joint was mobilized early. The bone united
in good time with no stiffness in the ankle joint. Weight bearing was however
delayed and allowed only once satisfactory x rays were there.