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J R Soc Med. 1988 January; 81(1): 19–21.
PMCID: PMC1291421

Ankle motion after external fixation of tibial fractures.


Loss of ankle movement is a complication of severe tibial fractures. This can be exacerbated if the foot is allowed to drop into equinus, particularly when an external fixator is employed. The range of ankle motion following external fixation of tibial fractures as compared to the opposite normal ankle was studied in 40 of 55 patients treated over a ten-year period. Nine were excluded due to other causes of ankle stiffness, leaving 31 cases for analysis. The mean follow up was 2 years 7 months (range 1 year to 8 years 3 months), and union had occurred by a mean of 35 weeks (range 9-100 weeks). The mean loss of ankle movement was 8 degrees of plantar-flexion and 12 degrees of dorsiflexion (overall loss 20 degrees), the difference between the two being highly significant (P greater than 0.001, t test). Loss of ankle motion closely paralleled the degree of soft tissue trauma, being 6 degrees for closed fractures and 22 degrees for open fractures (0.05 greater than P greater than 0.02). Ankle function is therefore at risk when a severe tibial fracture is treated by external fixation, and appropriate measures should be taken to preserve movement and prevent an equinus contracture.

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Selected References

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  • Behrens F, Searls K. External fixation of the tibia. Basic concepts and prospective evaluation. J Bone Joint Surg Br. 1986 Mar;68(2):246–254. [PubMed]
  • Edwards CC. Staged reconstruction of complex open tibial fractures using Hoffmann external fixation. Clinical decisions and dilemmas. Clin Orthop Relat Res. 1983 Sep;(178):130–161. [PubMed]
  • NICOLL EA. FRACTURES OF THE TIBIAL SHAFT. A SURVEY OF 705 CASES. J Bone Joint Surg Br. 1964 Aug;46:373–387. [PubMed]
  • Etter C, Burri C, Claes L, Kinzl L, Raible M. Treatment by external fixation of open fractures associated with severe soft tissue damage of the leg. Biomechanical principles and clinical experience. Clin Orthop Relat Res. 1983 Sep;(178):80–88. [PubMed]
  • Benum P, Svenningsen S. Tibial fractures treated with Hoffmann's external fixation: a comparative analysis of Hoffmann bilateral frames and the Vidal-Adrey double frame modification. Acta Orthop Scand. 1982 Jun;53(3):471–476. [PubMed]
  • Gershuni DH, Halma G. The A-O external skeletal fixator in the treatment of severe tibia fractures. J Trauma. 1983 Nov;23(11):986–990. [PubMed]
  • Karlström G, Olerud S. External fixation of severe open tibial fractures with the Hoffmann frame. Clin Orthop Relat Res. 1983 Nov;(180):68–77. [PubMed]
  • Vidal J, Buscayret C, Connes H, Melka J, Orst G. Guidelines for treatment of open fractures and infected pseudarthroses by external fixation. Clin Orthop Relat Res. 1983 Nov;(180):83–95. [PubMed]

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