Design and Use of an Ankle Joint-Bridging Two-Frame External Fixator for the Management of Complex Fractures and Dislocations in and Around the Ankle Joint

F. Krug; F. Lampe

doi:10.1055/s-2006-955222

Osteosynthesis and Trauma Care, Table of Contents

Osteosynthesis and Trauma Care 2006; 14(4): 233-238
DOI: 10.1055/s-2006-955222

Original Article

Design and Use of an Ankle Joint-Bridging Two-Frame External Fixator for the Management of Complex Fractures and Dislocations in and Around the Ankle Joint

F. Krug¹ , F. Lampe¹

¹Department of Orthopaedics and Traumatology, Klinik Eilbek, Schön Kliniken, Hamburg, Germany

Abstract

Purpose: The aim of this study was to design a standardized external system for the initial management of fractures and dislocations in and around the ankle joint; the system should be suitable as a temporary means of fixation prior to the use of a definitive technique (such as nailing or plating), or as a definitive technique in its own right. Method: A design specification was drawn up detailing the logistic, biomechanical, and clinical requirements to be met. A fixator design was developed to meet the specification. The concept involved details of existing fixator systems as well as innovative features. Results: The resulting design is presented. Compliance with the specification is discussed. The surgical technique required is described. The outcomes of the first 35 cases are reported. Advantages and disadvantages are discussed. Conclusion: The concept of the two-frame fixator has been found to be suitable, in surgical practice, for the management of injuries in and around the ankle joint.

Key words

fracture - dislocation - distal tibia - pilon - talus - calcaneus - external fixation

Full Text

References

1 Brug E, Westphal T. Die Pilon tibiale-Fraktur. In: Neumann H-S, Klein W, Brug E (Hrsg). Die dynamisch-axiale externe Fixation. Hans Marseille, Munich 1993
2 Buchal L, Asche G. Fixateur externe bei Sprunggelenksfrakturen. In: Asche G, Roth W, Schröder L (Hrsg). Fixateur externe. Einhorn Press, Reinbek 2002
3 Bühler M, Engelhard M, Schmidt H GK. Septische postoperative Komplikationen. Springer, New York 2003
4 Connes H. Die äußerliche Fixationseinrichtung nach Hoffmann. Diffinco S.A., Geneva 1978
5 Fernandez Dell'Oca A. External fixation. In: Rüedi TP, Murphy WM (eds). AO Principles of fracture management. Thieme, Stuttgart, New York 2000
6 Green S A. Ilizarov external fixation; technical and anatomic considerations. Bull Hosp Joint Dis. 1988; 48 28-35
7 Hahn M P, Thies J W. [Pilon tibiale fractures]. Chirurg. 2004; 75 211-230
8 Hontzsch D, Karnatz N, Jansen T. [One- or two-step management (with external fixator) of severe pilon-tibial fractures]. Aktuelle Traumatol. 1990; 20 199-204
9 Ilizarov G. Fractures and nonunions. In: Coombs R, Green SA, Sarmiento A (eds). External Fixation and Functional Bracing. Orthotext, London 1988
10 Kapandji I A. The physiology of the joints. In: Kapandji IA (ed). The limbs. Vol. 2. 5th edn. Churchill Livingstone, Edinburgh 1987
11 Kapukaya A, Subasi M, Arslan H. Management of comminuted closed tibial plafond fractures using circular external fixators. Acta Orthop Belg. 2005; 71 582-589
12 Kilian O, Bundner M S, Horas U, Heiss C, Schnettler R. [Long-term results in the surgical treatment of pilon tibial fractures. A retrospective study]. Chirurg. 2002; 73 65-72
13 Mockford B J, Ogonda L, Warnock D, Barr R J, Andrews C. The early management of severe tibial pilon fractures using a temporary ring fixator. Surgeon. 2003; 1 104-107
14 Patterson M J, Cole J D. Two-staged delayed open reduction and internal fixation of severe pilon fractures. J Orthop Trauma. 1999; 13 85-91
15 Pugh K J, Wolinsky P R, McAndrew M P, Johnson K D. Tibial pilon fractures: a comparison of treatment methods. J Trauma. 1999; 47 937-941
16 Rommens P M, Claes P, Broos P L. Therapeutic strategy in pilon fractures type C2 and C3: soft tissue damage changes treatment protocol. Acta Chir Belg. 1996; 96 85-92
17 Sirkin M, Sirkin M, Sanders R, DiPasquale T, Herscovici Jr D. A staged protocol for soft tissue management in the treatment of complex pilon fractures. J Orthop Trauma. 2004; 18 (Suppl 8) S32-S38
18 Sommer C, Rüedi T P. Tibia: distal (pilon). In: Rüedi TP, Murphy WM (eds). AO Principles of fracture management. Stuttgart, New York, Thieme, 2000
19 Stahl J P, Schnettler R. Klinische Beispiele für die Versorgung distaler Tibiafrakturen und des Pilon tibiale. In: Asche G, Roth W, Schröder L (Hrsg). Fixateur Externe. Einhorn Press, Reinbek 2002

Florian KrugM. D.

Department of Orthopaedics and Traumatology · Klinik Eilbek · Schön Kliniken

Dehnhaide 120

22081 Hamburg

Germany

Phone: +49/40/20 92 16 52

Fax: +49/40/20 92 12 95

Email: florian.krug@ak-eilbek.lbk-hh.de