[Ortho] crush distal tibia

[Dr. A. Liberson]

Agree in case you use Ex-Fix as well. If you do not-I do use both.
I find it usefull to have a grip on the fragments in case of need of change 
of the alignment.
The devascularisation of the bone is much less with the ex-fix.
 Generally-I would hesitate to I ndicate 1 proper treatment.
I still remember the times when the only proper tretment for pylons was a 
plate-things can change and we should try to change our methods up to the 
point we can.
I am inloved in IMN, still in this case I would use an Ex-Fix for the p-nts 
sake.
AL
----- Original Message ----- 
From: "Jeff Brooks" <orthoforum на weborto.net>
To: <ortho на weborto.net>
Sent: Wednesday, November 12, 2008 1:06 PM
Subject: Re: [Ortho] crush distal tibia


> My strong preference would be IM nailing in this case, with plate fixation 
> of the fibula with syndesmosis screw as well --if lateral soft tissues 
> allow, and perc the medial mall.
>
> CT scan showing articular injury will be helpful.
>
> I have never understood when folks refer to external fixation in severe 
> soft tissue trauma (IIIc tibias...) "to allow access to the wound"... I 
> can't think of a better way than IMN to "allow access to the wound".
>
> Jeff
>
>
>
>
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