Title: Complex fracture of the leg
Author: MIKE RASCHKE, BERLIN

PICTURES

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A case of a 48 years old polutraumatized female with multiple extremity injuries is presented.
The lady suffered a car rag and suffered a distal tibial fracture on the right side and a pilon tibial fracture of the left leg. The soft tissue situation was complicated by severe II - III ° burning of both legs and the abdominal region (30% of the body surface). In this special situation of a complex pilon fracture, injury of the contralateral leg and severe soft tissue situation an internal fixation a minimal invasive soft tissue preserving treatment is recommended.
Stabilisation of the pilon fracture was performed using composite Ilizarov fixation, combined with plating of the fibula and percutaneous screw fixation of the distal extra-articular tibia. After Ilizarov treatment the soft tissue situation consolidated and full weight bearing was allowed after 4 weeks. After 16 weeks of treatment osseous consolidation of the fracture region was achieved and after 2 weeks of dynamisation the Ilizarov fixator was removed.