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
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Presentation, Paper 249, AAOS National Meeting; 2003
D. J. BeckM. D.
Department of Orthopedic Surgery
University of Louisville
Louisville, Kentucky 40202
USA
Email: evansvilletrauma@adelphia.net
