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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.


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Connecting the rods

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

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


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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.


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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