- Discussion:
- most effective way to reduce pin bone stress and motion
- dynamization compensates for fragment end resorption;
- failure to adjust the fixator for maximum maintenance of fragment contact can leave the fracture surfaces fixed apart;
- Technique:
- adjust fixator to obtain good fragment apposition;
- apply compression across the fracture site & maintain stability thru application of gentle axial compression every few weeks;
- once frx shows evidence of healing consider loosening frame construct to allow controlled motion at the fracture site;
- frame is weakened by taking off top set of pin clamps or moving pin clamps further from the tibial shaft;
- fixator should be left on until fracture is non mobile, non painful, and radiographically healed;
- once sufficient callus is present, fixator is removed and treatment is completed with a cast or brace;
- if early fibular healing occurs, fibulectomy should be performed to permit impaction of the tibial fragment;
