1. PILON EXTERNAL FIXATION LAB

2. Theory of External Fixation  “Damage Control”  Provides stability while letting the soft tissues heal  Does not burn bridges  Allows for planning

3. Know the Goals of External Fixation  Provide stability  Restores length and rotation  Cannot anatomically reduce the joint  Does not control comminution

5. Options for Pin Placement  Tibia (typically 2 pins)  Talar neck  Calcaneus/Trans Calcaneal  1 st Metatarsal  Controls dorsiflexion of foot

6. Ways to Increase Stability  Increase number of pins  Increase pin spread  Decrease bar to skin distance  Add 2 nd bar  Add 2 nd plane

7. Successful External Fixation  Restoration of length and alignement  Soft tissue management  keep out of the way of future surgical site  Spend time to do a good exfix – it may be the definitive treatment

8. Complications  Pain  Infection  Loosening  Fracture