Reduction by manipulating the calcaneal pin

Reduce the fracture by manipulating the calcaneal pin. After checking correct reduction with image intensification, fix the reduced position by tightening all clamps.


Connecting the rods

To stabilize the construct, the two tibiocalcaneal rods may be connected with a short rod using rod-to-rod clamps.

A bent Steinmann rod can be used as an alternative to a straight rod if needed.


Tibiotarsal transfixation

To keep the foot in a neutral position, one or two small pins should be inserted

  • in one of the cuboids or
  • in the first metatarsal or
  • in the first and in the fifth metatarsal

and connected directly, or through a partial frame, with the tibial frame.


Alternative: Construct starting with a single tibial pin

To achieve a similar triangular construct, it is possible to start with one pin in the proximal third of the tibial crest instead of a partial frame.

Frame construction / reduction and fixation include the following steps:

  • Insertion of the tibial pin
  • Insertion of the calcaneal Steinmann pin
  • Connecting the two pins medially and laterally with two rods
  • Reduction by manipulating the calcaneal pin and fixation by tightening the clamps
  • Insertion of a stabilizing pin in the tibia proximal to the fracture through a rod-to-pin clamp on the medial rod
  • Tibiotarsal transfixation