The Damage Control Orthopedic (DCO) Footplate: A New Use of the Hoffmann II External Fixation System

Abstract

Recent literature supports the provisional fixation of fractures in polytraumatized patients with delayed limited open reduction and internal fixation when the soft tissue envelope and patient's medical condition permits [10] [11]. For fractures of the tibial pilon many external fixation systems use a footplate with thin wires originally designed for reconstruction and deformity correction to span the ankle joint [4] [5] [6] [7]. Others use a single point of fixation in the calcaneus (“A frame”) to provide initial stabilization of the lower extremity. However, control of the midfoot and forefoot with a footplate controls the reduction in deformity of pilon fractures and prevents equinus deformity. A footplate also provides a method to hold the heel off the bed preventing pressure ulcers in polytrauma patients. The small wire footplate is technically demanding and has limited degrees of freedom when positioned for attachment to a ring around the distal tibial fracture. A mid and forefoot controlling system can be made using the Hoffmann II compact system and an arch bar (Fig. [1]). The newly designed Hoffmann II footplate maintains the reduction of the plafond fracture and raises the foot off the bed. The footplate uses existing Hoffmann II components and retains its flexibility and modularity.

Fig. 1 Earlier construction of foot controlling pilon frame using Hoffmann II and Hoffmann II compact components.

Key words

Pilon - tibia fracture - external fixation

References

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