[Ortho] crush distal tibia

[DR ASSAD MUGHAL]

hi there. interesting case, very challenging
for a background, in our setting we comfortably nail the 3a tibias with a nail. now he came 2 day late but as u said no signs of infection. my only concern would be the soft tissue. if u are happy with them, nail it.
if not id slap on an exfix and hold this out to lenght and once the tissues are settled , id drop a nail in and address the ankle too.. plate the fibula and fix that malleolus.
alternatively..depending on your tissues, if it allows u to, id ORIF the ankle and get the fibula out to lenght and then mua that tibia (seems it will lock into each other based on the # configuration) and manage him in a pop with a window for wound care. all really depends on how the tissue injury is and what part is affected.

assad