Successful Integrated (External and Internal Fixation) Treatment of a Patient with Severe Distal Lower Leg Fracture in Conditions of Limited due to COVID-19 Pandemic Hospital Capacities

The result of successful integrated (external and internal fixation) treatment of a patient with a pylon fracture (43C3.2 according to AO/OTA classification) and concomitant somatic pathology is presented. Due to the COVID-19 pandemic, it was impossible to implement the standard soft tissue damage control orthopedics (DCO) protocol: The patient must be discharged from the hospital with a temporary external fixation, re-hospitalization for internal fixation is not possible. Therefore, reduction and local plating were performed using limited surgical approach. For final fixation, an additional Ilizarov ring frame was used. The device was dismantled in 126 days; the anatomical and functional result of the treatment is excellent.