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 TECHNIQUES FOR TREATMENT OF FRACTURES
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.
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.
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