[Ortho] crush distal ttibia

[Nikolaj Wolfson]

Marek:

First is soft tissue. In your case it would mean to me irrigation, debridement and temporarily external fixator( we call it traveling frame). Wound should be covered if you can not close it us wound vac, if you have it. Later ( within 6 day) use a flap if there is a problem.
I would not open fibulla. Why to rash, you have ex fix doing for you what you need. Let soft tissues to calm down, swelling to go away and than nail tibia after you ORIF fibula and fix the syndesmosis if needed after your nailing is done.  Do CT scan to assess the distal tibia for possible articular extension.

Nik

Nikolaj Wolfson, MD, FRCSC
Assistant Professor of Orthopaedic Surgery
Department of Orthopaedic Surgery
Keck School of Medicine
University of Southern California