Fracture of the Tibial Metaphysis after traumatic injury

Preop CT Scan of Metaphysis fracture prior to repair below


Below is a post-surgical x -ray of a fracture of the metaphysis after repair with screws and wires, one of which is a wire that was  placed percutaneously (through the skin) and was then later removed.    

Below is post-surgical films several weeks after repair after the percutaneous fixation pin was removed.


Below, Preop Displaced Pilon Fracture

Below, After Ex Fix was placed to stabilize and temporarily reduce fracture

Below, Ex Fix is removed and ORIF performed. Reduction of fracture is complete. 

This a series of Xrays in a woman with Diabetes, poor vascularity and neuropathy. This injury was initially stabilized using an Ex Fix. After, definitive repair was performed using percutaneous plates and screws. This is a minimally invasive surgery that only requires small stab incisions to place the hardware. This significantly decreases the chances of complications.

This is Preop xrays of the displaced pilon fracture

These are pictures of reduction with Ex Fix

These are intraoperative xrays showing the repair as well as small stab incisions used under fluoroscopic guidance

These are final intraop xrays showing excellent positioning and reduction of this devastating injury,

Below, a displaced tibia metaphysis and fibula fracture is seen. Due to the soft tissue damage with this type of injury, reduction is performed in two stages. In Stage 1, an ex-fix is placed to hold the joint and fractures in reduction. Once the soft tissue envelope is stabilized, a definitive ORIF of the fracture is performed

Stage 1

Stage 2


Subtle Fracture in Toddler (below)


Wedging of cast to keep a tibia fracture well aligned. We wedge the cast on a side if there is malalignment early on in the fracture healing to realign the fracture