[Ortho] crush distal tibia

[Odessky Jacob]

Dear colleague! Do you use in yours practice Ilizarov apparatus? If yes, his technique is a method of choice for this case. 
I agree with the doctor Wolfson that soft tissue more important than fracture at the first stage of management of patient. Therefore good debridement of the wound with removal of all devitalized tissues is extremely important. 
How can you use Ilizarov techniques for soft tissues? You can essentially decrees the sizes of the wound by dublication of bone fragments having created shortening and \or angular deformity.With the subsequent restoration of length and an axis of a segment by Ilizarov apparatus. 
This technique is well described by doctor Lerner in his book – A. Lerner · D. Reis · M. Soudry 
“Severe Injuries to the Limbs. Staged Treatment” 
If you need more recommendations about this technique, you may address to me. 
All the best. 

Odessky Jacob M.D. 
Orthopedic Division 
Assaf Harofeah Medical Center 
Zerifin, Israel