[External fixator for temporary stabilization of complex periarticular knee fractures]

Abstract

Objective: Temporary stabilization of the knee joint in order to minimize soft tissue strain until definitive surgery is possible.

Indications: Bicondylar distal femoral and tibial plateau fractures, additional vascular injury, open fractures (second or third degree), severe soft tissue damage, unicondylar fracture with contralateral ligament tear, (open) knee dislocation, polytrauma.

Contraindications: Unsafe pin placement, severe osteoporosis.

Surgical technique: Two femoral and tibial pins are connected by two rods and are spanned over the knee with two additional longitudinal rods via a tube-to-tube clamp. Alternatively, this can be facilitated by a direct connection of two rods in case of anteriorly placed femoral pins. A reasonable distance should be kept to open wounds, the fracture, and later operative approaches. The knee is fixed in 5-15° of flexion.

Postoperative management: Definitive treatment depending on patient well-being and amenable soft tissue.

Keywords: Definitive care; Knee joint dislocations; Open fractures; Severe soft tissue damage; Surgical technique.