Tibia bifocal fx inveterated

Patient, 50 years old, after polytrauma. Reached our hospital after 1 month: temporary tibia stabilisation, luxation hip joint.

 

 

 

 

 

 

Procedure: 

  1. Removal of the Fix. ex pins from the knee joint (Fix ex - femur-tibia distal), correction of deformity diaphyseal with 2 small plates (at risk: before exposed fractures).
  2. Osteosynthesis of acetabulum fracture - (poor fragment quality after calloclassia)

After 1 week we approached the knee with posteromedial approach: "calloclassia" of the major fragment from posterior and anterior, posteromedial reduction and plating from medial. See the positioning of the patient with the fix ex still in sitú:

 

 

 

 

 

 

 

 

 

Then MIS plating in supine position on the lateral tibial side.

postoperative x-ray: small reduction plates fro tibial diaphysis still left in place (we had to remove them soon, because of local infection at the exposure side of the fracture)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hip: failure of plating: prosthetic replacement with reconstruction of acetabular wall.

 

 

 

 

 

 

 

 

 

 

Link: next step - treatment of the osteomyeltis of the tibial fragments

Link: similar case of bifocal tibia fracture