[Ortho] crush distal ttibia

[Ivan Petrov]

Due to soft tissue coverage about distal tibia and ankle has a poor blood supply, in high-energy fracture there is high frequency and severe consequences of complications secondary to early ORIF.
I recomend next options (subject to You skill in handling):
1. Ilizarov frame as definitive managment (it is crucial to perform high-quality about ankle fixation for early distal ring removing and ROM restoration) - see photo. 
2. Cross-Ankle external fixation - 1 stage.
After severe soft tissue edema and necrosis resolving - tibial nailing, percutaneous syndesmosis and medial malleolus screw fixation.
Ivan Petrov