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[Complementary osteosynthesis and dynamic axial fixation of the distal tibia].

In view of the problems encountered with fractures of the distal tibial shaft, with or without damage to the ankle joint, we have developed a regimen of our own. We reconstruct the fracture by means of simple techniques (K-wires or one to three screws), taking the greatest possible care to avoid damage to the soft tissues. The length and axis of the lower leg are maintained by means of a unilateral fixator, which can also be used for decompression of the ankle joint in a joint-bridging modification. The two components of our regimen complement each other, and we have therefore coined the phrase "complementary osteosynthesis". Evaluation of data in 15 patients who had suffered trauma at least 1 year earlier and in whom the follow-up period was a mean of 86.8 weeks showed that results classified as good or fair can be achieved even in these problematic fractures.