A device for improved reduction of tibial fractures treated with external fixation

A widely used method of treatment for unstable tibial shaft fractures is un ilateral external fixation. The majority of fixators act as three distinct devices: an intra-operative reduction device, a device to maintain fracture alignment during healing and an aid to healing by allowing movement at the fracture site. Conventional operative techniques require the surgeon to ma nipulate a number of degrees of freedom at once, making reduction of the fr acture difficult, and results in the fixator being out of alignment with th e long axis of the bone. An operative method has been developed that separa tes reduction and fixation. A dedicated device has been designed to improve the per-operative control of fracture fragments during fracture reduction. The device has been used in clinical trials for the reduction of 22 diaphy seal tibial fractures. Compared with previous operative techniques there ha s been a saving of 53 per cent in fracture reduction time and an overall sa ving of 10 per cent in operating time. Fracture alignment has been improved compared with reductions achieved with a fixator which potentially improve s healing and lowers the rate of malunion. In each case the fixator has bee n applied in alignment with the bone, improving dynamization and reducing t he likelihood of malunion due to fixator cam slippage.