Management of an open tibia fracture with an external fixator
How to debride a tibia and apply an exfix
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Open Fracture Grade 1 - any fracture with a wound in the region must be regarded as an open fracture and the wound explored in theater |
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X-ray of the tibia |
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Scrubbing the leg prior to surgery |
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The debridement. Curetting the marrow cavity - this may be contaminated by debris. In this case the original wound needed extension to gain access to the tibia. Irrigate and excise all dead tissue. |
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The AO external fixator has been applied |
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Postoperative x ray showing good alignment |
External fixators in other regions
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Pelvic reduction clamp. Used for emergency reduction of unstable open book pelvic fractures |
An exfix is an effective, and potentially life saving procedure in open book type pelvic fractures. A Gantz clamp is placed over the pelvis with the pins over the sacro ilaic joint. It will effectively reduce the fracture and prevent haemorrage.
Forearm fractures
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Distal radius fractures can be stabilised and held at length by means of an exfix from the proximal radius to the second metacarpal bone.
The indication a comminuted fracture of the distal radius with loss of length. In the forearm closed as well as open fractures can be treated by this method.