Executive Editor: Peter Trafton

Authors: Martin Hessmann, Sean Nork, Christoph Sommer, Bruce Twaddle

Distal tibia

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Supine position (fracture table)

Supine position on fracture table

Application of a ring fixator requires circumferential access to the leg. Additionally, the fracture should be aligned.

Open reduction and fixation of the tibial articular surface and / or fibula may be done as a first stage. This is often easier with the leg free on the table surface, using a distractor or external fixator if desired. Thereafter, leg suspension, as illustrated with the fracture table, eases application of the ring fixator.

Instead of a fracture table, the leg may be supported with a proprietary mobile reduction frame, or one improvised from modular external fixator components.

Consider use of a tourniquet if articular surface ORIF will be an initial stage. Prep the leg from mid-thigh to toes.

v1.0 2008-12-03