Synthes
Basic principles
– Restore the articular surface. Screw fixation must be used
to provide interfragmentary compression after anatomic
reduction of the articular surface. Bone graft may be
necessary for any metaphyseal defect.
– Opposing spade-point reduction wires may be used.
6,7
They prevent frame movement and are helpful in the
reduction of small fragments. When using spade-point
reduction wires, insert the wire until the “olive” contacts
the bone surface (Figure 4). Washers can be used in
osteopenic bone.
– To increase frame stability, the proximal pin on the anterior
rod should be 2 cm distal to the fracture, and the second
pin should be as far distal as possible. To accommodate
pins placed in differing planes, modular frame technique,
using more than one carbon fiber rod, can be used in place
of the anterior frame. (See the
Basic Modular Frame
Technique Guide.
)
– A second carbon fiber rod must be placed either laterally
or medially for optimal stability. If desired, a third rod can
be added on the opposite side.
– Preoperative planning of clamp and ring placement should
take into consideration future x-ray visibility of both the
joint line and the fracture site.
– To achieve fine distraction, Open Compressors (393.76)
can be used as illustrated (Figure 5). For more information,
consult the
Open Compressor Technique Guide
.
Figure 5
Figure 4
6. G.L. Orbay, V.H. Frankel and F.J. Kummer. “The Effect of Wire Configuration
in the Stability of the Ilizarov External Fixator.”
Clinical Orthopaedics and Related
Research.
1992;279. 299–302.
7. Kummer. op cit..
