Treatment of Intra-Articular and Segmental Diaphyseal Open Fractures of the Same Lower Leg

The case presents a staged treatment of a patient with a closed fracture of the tibial plateau (41C1 according to AO/OTA classification) and an open diaphyseal (III B according to G-A classification, and 42C3 AO/OTA classification) fracture of the same lower leg. The wound debridement and temporary fracture stabilization with tubular frame were performed at hospitalization. On the 17th day a transition was made from temporary external fixation to definitive ring external fixation with anatomical reduction of the intra-articular fracture of the tibial plateau. On 82nd day, due to the signs of delayed union and mal-alignment, additional correction (alignment and shortening for adaptation of bone fragments) was performed using an orthopedic hexapod. By the 276th day from the moment of injury, the consolidation of the diaphyseal fracture was achieved with a segment shortening by 3.0 cm. The final stage, during 173 days, limb length discrepancy (LLD)Limb length discrepancy (LLD) was eliminated according to Ilizarov. The total treatment period was 449 days. The anatomical and functional outcome of the treatment is good.