Principles of definitive care
The external fixator, or pinning, maintains bony stability for soft-tissue
management. Once soft tissues are closed, or appropriate for surgery,
definitive bony fixation is undertaken. Accurate reconstruction of joint
surfaces with spanning plates over areas of marked comminution provide
stability and enhance bony healing and soft-tissue care.
Foot shape and proper position of comminuted bone pieces is maintained by
locking implants. This is one of the few places in the body where whole bones
can be spanned if joints are accurately reconstructed.
Long spanning plates are best left in place for a period of months while the
bony and soft-tissue injuries heal.