Use of the External Fixator Calcaneus Pin: Using the TRIMANO to Its Full Potential
Joint-spanning external fixation in acute ankle trauma is a means to provide temporary stability and restoration of length, alignment, and articular congruency. This allows for soft-tissue consolidation before definitive fixation to decrease the risk of wound complications. Traction is commonly used...
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| Published in: | Arthroscopy techniques (Amsterdam) Vol. 11; no. 4; pp. e669 - e673 |
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Elsevier Inc
01-04-2022
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| Abstract | Joint-spanning external fixation in acute ankle trauma is a means to provide temporary stability and restoration of length, alignment, and articular congruency. This allows for soft-tissue consolidation before definitive fixation to decrease the risk of wound complications. Traction is commonly used during definitive fixation to aid in fracture reduction and to maintain reduction during placement of internal hardware. Ankle arthroscopy for ankle fractures is also becoming increasingly popular to identify and treat intra-articular injury and uses traction for visual assistance and increased working space for instruments. We present a technique that uses a previously placed calcaneus external fixation pin and the TRIMANO (Arthrex, Naples, FL) external positioning arm to apply skeletal traction during arthroscopic and open definitive fixation procedures. This technique is extremely simple, can be used in both the supine and prone positions, and can be used during arthroscopic and open procedures.
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| AbstractList | Joint-spanning external fixation in acute ankle trauma is a means to provide temporary stability and restoration of length, alignment, and articular congruency. This allows for soft-tissue consolidation before definitive fixation to decrease the risk of wound complications. Traction is commonly used during definitive fixation to aid in fracture reduction and to maintain reduction during placement of internal hardware. Ankle arthroscopy for ankle fractures is also becoming increasingly popular to identify and treat intra-articular injury and uses traction for visual assistance and increased working space for instruments. We present a technique that uses a previously placed calcaneus external fixation pin and the TRIMANO (Arthrex, Naples, FL) external positioning arm to apply skeletal traction during arthroscopic and open definitive fixation procedures. This technique is extremely simple, can be used in both the supine and prone positions, and can be used during arthroscopic and open procedures.
Video 1
Intra-operative video demonstration of the TRIMANO (Arthrex, Naples, FL) external positioning arm applying ankle distraction through a previously placed calcaneus external fixation pin. Joint-spanning external fixation in acute ankle trauma is a means to provide temporary stability and restoration of length, alignment, and articular congruency. This allows for soft-tissue consolidation before definitive fixation to decrease the risk of wound complications. Traction is commonly used during definitive fixation to aid in fracture reduction and to maintain reduction during placement of internal hardware. Ankle arthroscopy for ankle fractures is also becoming increasingly popular to identify and treat intra-articular injury and uses traction for visual assistance and increased working space for instruments. We present a technique that uses a previously placed calcaneus external fixation pin and the TRIMANO (Arthrex, Naples, FL) external positioning arm to apply skeletal traction during arthroscopic and open definitive fixation procedures. This technique is extremely simple, can be used in both the supine and prone positions, and can be used during arthroscopic and open procedures. Joint-spanning external fixation in acute ankle trauma is a means to provide temporary stability and restoration of length, alignment, and articular congruency. This allows for soft-tissue consolidation before definitive fixation to decrease the risk of wound complications. Traction is commonly used during definitive fixation to aid in fracture reduction and to maintain reduction during placement of internal hardware. Ankle arthroscopy for ankle fractures is also becoming increasingly popular to identify and treat intra-articular injury and uses traction for visual assistance and increased working space for instruments. We present a technique that uses a previously placed calcaneus external fixation pin and the TRIMANO (Arthrex, Naples, FL) external positioning arm to apply skeletal traction during arthroscopic and open definitive fixation procedures. This technique is extremely simple, can be used in both the supine and prone positions, and can be used during arthroscopic and open procedures. [Display omitted] |
| Author | Martin, Kevin D. Umbel, Benjamin D. Washburn, Frederic J. |
| Author_xml | – sequence: 1 givenname: Frederic J. orcidid: 0000-0002-1354-4133 surname: Washburn fullname: Washburn, Frederic J. email: fwashburn@cmhshealth.org organization: Community Memorial Health System, Ventura, California, U.S.A – sequence: 2 givenname: Benjamin D. orcidid: 0000-0002-1416-6509 surname: Umbel fullname: Umbel, Benjamin D. organization: Doctor’s Hospital, Columbus, Ohio, U.S.A – sequence: 3 givenname: Kevin D. surname: Martin fullname: Martin, Kevin D. organization: Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35493051$$D View this record in MEDLINE/PubMed |
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| References | Hirtler, Rath, Kügler, Reissig, Willegger (bib8) 2021; 37 Rammelt, Endres, Grass, Zwipp (bib1) 2004; 9 Kamin, Rammelt, Kleber, Marx, Schaser (bib2) 2020; 32 Chiang, Tzeng, Jeff Lin, Wang, Lin, Chang (bib5) 2019; 35 Martin, Tripp, Huh (bib6) 2021; 42 Chen, Chen, Liu, Yang, Xu, Lin (bib3) 2015; 31 Unangst, Martin (bib9) 2015; 4 Hirtler, Schellander, Schuh (bib7) 2019; 40 Liu, You, Yang (bib4) 2020; 36 Liu (10.1016/j.eats.2021.12.022_bib4) 2020; 36 Martin (10.1016/j.eats.2021.12.022_bib6) 2021; 42 Chen (10.1016/j.eats.2021.12.022_bib3) 2015; 31 Rammelt (10.1016/j.eats.2021.12.022_bib1) 2004; 9 Hirtler (10.1016/j.eats.2021.12.022_bib7) 2019; 40 Unangst (10.1016/j.eats.2021.12.022_bib9) 2015; 4 Kamin (10.1016/j.eats.2021.12.022_bib2) 2020; 32 Chiang (10.1016/j.eats.2021.12.022_bib5) 2019; 35 Hirtler (10.1016/j.eats.2021.12.022_bib8) 2021; 37 |
| References_xml | – volume: 35 start-page: 2671 year: 2019 end-page: 2683 ident: bib5 article-title: Arthroscopic reduction and minimally invasive surgery in supination-external rotation ankle fractures: A comparative study with open reduction publication-title: Arthroscopy contributor: fullname: Chang – volume: 42 start-page: 157 year: 2021 end-page: 165 ident: bib6 article-title: Outcomes of posterior arthroscopic reduction and internal fixation (PARIF) for the posterior malleolar fragment in trimalleolar ankle fractures publication-title: Foot Ankle Int contributor: fullname: Huh – volume: 40 start-page: 978 year: 2019 end-page: 986 ident: bib7 article-title: Accessibility to talar dome in neutral position, dorsiflexion, or noninvasive distraction in posterior ankle arthroscopy publication-title: Foot Ankle Int contributor: fullname: Schuh – volume: 4 start-page: e873 year: 2015 end-page: e876 ident: bib9 article-title: Simple 1-step ankle arthroscopy distraction publication-title: Arthrosc Tech contributor: fullname: Martin – volume: 37 start-page: 1245 year: 2021 end-page: 1257 ident: bib8 article-title: Maximum ankle plantarflexion and dorsiflexion allow for optimal arthroscopic access to the talar dome: An anatomic 3-dimensional radiography study publication-title: Arthroscopy contributor: fullname: Willegger – volume: 31 start-page: 2224 year: 2015 end-page: 2231 ident: bib3 article-title: Arthroscopy-assisted surgery for acute ankle fractures: A systematic review publication-title: Arthroscopy contributor: fullname: Lin – volume: 9 start-page: 455 year: 2004 end-page: 474 ident: bib1 article-title: The role of external fixation in acute ankle trauma publication-title: Foot Ankle Clin contributor: fullname: Zwipp – volume: 36 start-page: 1714 year: 2020 end-page: 1721 ident: bib4 article-title: Arthroscopy-assisted reduction in the management of isolated medial malleolar fracture publication-title: Arthroscopy contributor: fullname: Yang – volume: 32 start-page: 421 year: 2020 end-page: 432 ident: bib2 article-title: External fixator: Temporary fixation and soft tissue management of the ankle publication-title: Oper Orthop Traumatol contributor: fullname: Schaser – volume: 36 start-page: 1714 year: 2020 ident: 10.1016/j.eats.2021.12.022_bib4 article-title: Arthroscopy-assisted reduction in the management of isolated medial malleolar fracture publication-title: Arthroscopy doi: 10.1016/j.arthro.2020.01.053 contributor: fullname: Liu – volume: 31 start-page: 2224 year: 2015 ident: 10.1016/j.eats.2021.12.022_bib3 article-title: Arthroscopy-assisted surgery for acute ankle fractures: A systematic review publication-title: Arthroscopy doi: 10.1016/j.arthro.2015.03.043 contributor: fullname: Chen – volume: 32 start-page: 421 year: 2020 ident: 10.1016/j.eats.2021.12.022_bib2 article-title: External fixator: Temporary fixation and soft tissue management of the ankle publication-title: Oper Orthop Traumatol doi: 10.1007/s00064-020-00677-5 contributor: fullname: Kamin – volume: 37 start-page: 1245 year: 2021 ident: 10.1016/j.eats.2021.12.022_bib8 article-title: Maximum ankle plantarflexion and dorsiflexion allow for optimal arthroscopic access to the talar dome: An anatomic 3-dimensional radiography study publication-title: Arthroscopy doi: 10.1016/j.arthro.2020.12.207 contributor: fullname: Hirtler – volume: 40 start-page: 978 year: 2019 ident: 10.1016/j.eats.2021.12.022_bib7 article-title: Accessibility to talar dome in neutral position, dorsiflexion, or noninvasive distraction in posterior ankle arthroscopy publication-title: Foot Ankle Int doi: 10.1177/1071100719847134 contributor: fullname: Hirtler – volume: 4 start-page: e873 year: 2015 ident: 10.1016/j.eats.2021.12.022_bib9 article-title: Simple 1-step ankle arthroscopy distraction publication-title: Arthrosc Tech doi: 10.1016/j.eats.2015.08.017 contributor: fullname: Unangst – volume: 9 start-page: 455 year: 2004 ident: 10.1016/j.eats.2021.12.022_bib1 article-title: The role of external fixation in acute ankle trauma publication-title: Foot Ankle Clin doi: 10.1016/j.fcl.2004.05.001 contributor: fullname: Rammelt – volume: 35 start-page: 2671 year: 2019 ident: 10.1016/j.eats.2021.12.022_bib5 article-title: Arthroscopic reduction and minimally invasive surgery in supination-external rotation ankle fractures: A comparative study with open reduction publication-title: Arthroscopy doi: 10.1016/j.arthro.2019.03.051 contributor: fullname: Chiang – volume: 42 start-page: 157 year: 2021 ident: 10.1016/j.eats.2021.12.022_bib6 article-title: Outcomes of posterior arthroscopic reduction and internal fixation (PARIF) for the posterior malleolar fragment in trimalleolar ankle fractures publication-title: Foot Ankle Int doi: 10.1177/1071100720955149 contributor: fullname: Martin |
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| Title | Use of the External Fixator Calcaneus Pin: Using the TRIMANO to Its Full Potential |
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