Rationale for Patient Selection
- 66-year-old, right-hand-dominant female fell down the stairs and sustained a left, displaced, 3-part fracture as well as a left tibial plateau fracture
- Uncontrolled diabetic with BMI of 31 and HgbA1c of 8.2
Assessment of Injury
- Images show more than 50% displacement
- The greater tuberosity is fractured but not displaced
External Fixator Placement
- Total operative time for placement: Not captured due to the need for additional time for external fixation of the knee
- Images taken in the OR one day after pin placement demonstrate good superior and inferior spread as well as good anterior to posterior spread
Post-op Progress
Week 8: Continued good pin placement
Seven Months: The patient reports no pain. Active range of motion was good for the most part with forward flexion at 120° and external rotation at 30°. Internal rotation, which is typically the most challenging range of motion to improve, was to the iliac crest
Outcomes Achieved
- Good healing and alignment
- No signs of infection
- The patient reports no pain
- Good active range of motion with somewhat diminished internal rotation
- Forward flexion 120°
- Internal rotation 30°
- Internal rotation to iliac crest