External Fixation in Fracture Treatment

A 34-year-old member of the New York Fire Department (NYFD) was fighting a fire on the 4th floor of an apartment building. His fire unit was rapidly overcome by the spreading blaze and had no little choice but to jump from the building.

He landed on the pavement below and sustained multiple injuries including an atlanto-occipital dislocation, pelvic fracture and a severe distal tibial pilon fracture and associated fibula fracture. He was given a 5 percent chance of survival.

New York Presbyterian/Weill Cornell neurosurgeon, Dr. Roger Hartl, performed surgery to repair the spinal cord injury; and Orthopaedic Surgeons Dr. Helfet and Dr. Lorich addressed the pelvic fracture and the distal tibia fracture.

A spanning external fixator was placed for initial fixation with concurrent fibula ORIF including placement of a Locking Compression Plate (LCP). Open reduction and internal fixation of the pilon fracture was performed one week later through an anteromedial approach with placement of plates and screws (LCP medially and pelvic reconstruction plate anterolaterally).

After eight months of recovery in the hospital he walked out of the hospital. He has returned for regular follow-up intervals and radiographs revealed healing of his fractures. At 14 months following his injuries he presented with good results with a healed distal tibia and pelvic fracture and he has also made a good clinical recovery.

  • Figure A

    Figure A

    Anteroposterior (AP) and lateral x-rays reveal an AO/OTA Type 43-C3 distal tibia pilon fracture with extensive articular involvement; (right images) AP and lateral x-rays of the right ankle following placement of a spanning external fixator; (top images) CT scan images delineating the articular fracture lines.

    Enlarge

  • Figure B

    Figure B

    Preoperative plan for open reduction and internal fixation (1 week following placement of a spanning external fixator and fibula plating).

    Enlarge

  • Figure C

    Figure C

    Radiographs at 14 months following ORIF illustrating a healed pilon fracture with maintenance of joint space and fixation.

    Enlarge

Tags: , , ,

Our Patients

  • “I was able to return to my passion, which was skiing big mountains.”

    ~ Tim DiPietro

    Read Full Story

  • “I thank the doctors at NYP/HSS for giving me my life back.”

    ~ Caitlyn Kearns

    Read Full Story

  • “There was the possibility for the first time to live a full and adventurous life that I had always dreamed of.”

    ~ Devon Reynolds

    Read Full Story

  • “Dr. David Helfet had looked at my leg, immediately rushed me to the OR and did a 4 compartment release saving my only leg!”

    ~ Dawn Bray

    Read Full Story

  • “The entire hospital staff were just amazing from the instant we rolled through the doors throughout the entire stay.”

    ~ Victor Katz

    Read Full Story

  • “The level of expertise and care is beyond imagination. Dr. Helfet is an artist.”

    ~ Herve Duteil

    Read Full Story

  • “I got back up on my snowboard a month ago!”

    ~ Patricia Sykes

    Read Full Story

David L. Helfet, MD

535 East 70th Street
New York, NY 10021

212-606-1888 phone
212-628-4473 fax

New York Fracture Care

Contact Us

David L. Helfet, MD 
212-606-1888

Dean G. Lorich, MD
212-746-4509

David S. Wellman, MD
212-606-1504