Hybrid Fixator—Distal Tibia Frame
Synthes
Hybrid Fixator—Distal Tibia Frame Technique Guide
When to use
The hybrid frame is used for the stabilization of complex
distal tibial fractures, particularly those involving the joint.
Wire positioning
Proper wire positioning follows these basic guidelines:
– Use a minimum of two wires with a separating angle of
at least 60° and approaching 90° when possible.
1
Ideally,
the wires should intersect in the center of the bone.
– Wires may be positioned at different levels using the
adjustable wire/pin clamp.
– An adequate incision should be made at wire and Schanz
screw insertion points to avoid skin tenting and soft tissue
irritation. Wires should be straight for the same reason.
– Place an additional Schanz screw or third wire in the distal
fragment for stability. If a Schanz screw is used, it should
be placed above the ring and angled distally to maximize
thread purchase in the bone.
– The anatomy surrounding the distal portion of the tibia
should be taken into consideration for wire placement
(Figure 1).
– Place wires within the distal fragment and proximal to
interfragmentary screws (Figure 2).
Wire
A
1
A
2
B
Figure 1
Typical wire positions, as noted on diagram:
A. Wire can be placed either lateral to medial (A1) or
posterolateral to anteromedial through the fibula (A2)
B. Posteromedial to anterolateral tibia
Figure 2
1. F.J. Kummer. “Biomechanics of the Ilizarov External Fixator.”
Clinical Orthopaedics and Related Research
. 1992;280. 11–14.
