Physician's Resources: Fracture Repair


Surgical management of fractures in the distal tibia, ankle and foot can be performed by two methods:

  1. Internal Fixation: consist of realigning the fracture site and inserting metallic screws and plates for proper compression. This method requires non-weight bearing status for 6-8 weeks followed by physical therapy.
  2. External Fixation: consist of realigning the fracture site by means of inserting wires through the skin and bone (transosseous) and attaching them to a circular or monolateral frame. The External fixator serves as a cast, but with the advantage of also applying internal compression. This technique allows the patients almost immediate ambulation and early range of motion.

Different Techinques for Treatment of Fractures


External Fixation for Distal Articular Fracture

External Fixation for Tibial Articular Fracture

Ankle Fracture Before External Fixation Treatment

Ankle Fracture After External Fixation Treatment

Ankle Fracture After External Fixation Treatment
 
Case Presentation: Ankle fracture managed by application of monolateral external fixator for a period of 8 weeks with initial partial weight-bearing to full weight-bearing as tolerated.
Outcome: Proper anatomical alignment of the medial and lateral malleolus and removal of external fixator at 8 weeks followed by physical therapy. Achieving full range of motion and strength of the extremity.
*Personal result will be discussed with possible candidates per request.

Initial Appearance Calcaneal Fracture

CT scan showing articular damage with malalignment

Back view of External Fixation for correction of Calcaneal Fracture

Front view of External Fixation for correction of Calcaneal Fracture

Final Xrays showing proper alignment

Standing front view showing equal Anatomical Alignment of both Extremities
Case Presentation: Acute calcaneal fracture (heel fracture) treated with the application of external fixation without any open reduction of the fracture fragments.
Outcome: Proper alignment of the subtalar joint and restoration of the height of the calcaneus. This was accomplished by gradual distraction of the external fixator. Partial to full weight-bearing status was recommended and removal of the fixator was performed at 10 weeks.
*Personal result will be discussed with possible candidates per request.