Journal of Emergencies, Trauma, and Shock
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CASE REPORT
Year : 2015  |  Volume : 8  |  Issue : 1  |  Page : 61-64

Emergency department external fixation for provisional treatment of pilon and unstable ankle fractures


Department of Orthopaedic Surgery, Division of Orthopaedic Trauma, Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island, USA

Correspondence Address:
Craig R Lareau
Department of Orthopaedic Surgery, Division of Orthopaedic Trauma, Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2700.150400

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Unstable ankle fractures and impacted tibial pilon fractures often benefit from provisional external fixation as a temporizing measure prior to definitive fixation. Benefits of external fixation include improved articular alignment, decreased articular impaction, and soft tissue rest. Uniplanar external fixator placement in the Emergency Department (ED ex-fix) is a reliable and safe technique for achieving ankle reduction and stability while awaiting definitive fixation. This procedure involves placing transverse proximal tibial and calcaneal traction pins and connecting the pins with two external fixator rods. This technique is particularly useful in austere environments or when the operating room is not immediately available. Additionally, this bedside intervention prevents the patient from requiring general anesthesia and may be a cost-effective strategy for decreasing valuable operating time. The ED ex-fix is an especially valuable procedure in busy trauma centers and during mass casualty events, in which resources may be limited.


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