Just had similar case. Bad local soft tissue. I did closed reduction with a cłamp, percutanous fix of Syndesmosis and medial maleollus ExFix.

They play soccer in the school yard with the exfix on. Don’t ask me how I know…

It’s a great idea for an adult and I have done it, but I’ve never put on an exfix in a patient this young. I wonder how it would be tolerated, would it be more or less frightening than having cast changes wound checks and all the annoyances of having a cast in the first place?

Less ‘tibial plateau meniscus’ more ‘moore type 2 fracture dislocation’ Agree with exfix, and any sniff of compartment at time if exfix id be doing fasciotomies. Dont 100% agree on ‘all 4 compartments laid bare top to bottom’ - i think there’s nuance to address pathology

Brave soul who did an exfix and placed a pressure monitor then sat on a compartment pressure of 70 for a few hours. Hope the pat had a diastolic of >100 🫤 Even the settled pressure of 40 is mega sketchy

A quick look at the external fixation of the pelvis: Correct pin placement is the foundation of stable fixation when placing external fixators. #orthopaedics #trauma #ExFix #Pelvis #orthotwitter #orthoX #meded

Here are intraop & postop images of yesterday's case by Dr. Michael Maceroli and @NorthsideHospital Orthopedics - Orthopedic Trauma Specialists. OPEN DISTAL FEMUR FRACTURE IN 43M PROCEDURE 1: I&D OF THE FEMUR AND EXFIX PLACEMENT PROCEDURE 2: NAIL AND PLATE COMBINATION WITH MEDIAL PLATE Here is the link to the clinical presentation and the pre-op imaging: x.com/orthobullets/status/20… Do you agree with the treatment? Why or why not? Leave a comment and keep the great conversation going! #orthotwitter Vote on this case for CME: orthobullets.tiny.us/2p8d375…

Here is an injury x-ray taken prior to I&D of the femur and ExFix placement.

Agree with this. Those segmental fractures are really hard to control with that kind of exfix setup anyway. In addition to the pin with the “crack”, another one is actually through the proximal fracture site.

Was it open and what grade? What are the pin sites looking like? Remove ExFix; 2 weeks of plaster, then nail.

Take off exfix. Pin holiday. Then nail after 2 wks. If can’t tolerate pin holiday then curette tracts, but some time without exfix pins is better

Charcot reconstruction with osteotome, exfix and bone stimulator youtube.com/watch?v=xl4d3o0c…

That exfix will be on for up to 6 weeks. She has at least 1 more surgery coming. She will not be able to weight bear for 3 months probably. And her ACL is still torn on that side!

Orthopedic surgeons in the US when they see that ExFix device.

A quick look at the external fixation of the pelvis: Correct pin placement is the foundation of stable fixation when placing external fixators. #orthopaedics #trauma #ExFix #Pelvis #orthotwitter #orthoX #meded

Mentally unwelll.. getting another exfix in February

Watch how a broken bone gets realigned and saved using an External Fixator (ExFix) ✨ Orthopaedics is not for the faint-hearted. Healing, engineering, and precision all in one frame.

คนไข้ชั้นขอนขาใส่exfixอยู่รพ. พัสดีบอกให้เอาคนไข้d/c

Here are intraop & postop images of yesterday's case by Dr. Krystin Hidden @KrystinHiddenMD and @MayoClinic. OPEN PILON FRACTURE IN 56M HUNTER PROCEDURE: STAGED PILON FRACTURE ORIF FOLLOWING EXFIX TEMPORIZATION This case is sponsored by the @FOTNorthAmerica Lower Extremity Dissection Course and 16th Annual Meeting in Las Vegas, NV, Jan 29-30, 2026. Here is the link to the clinical presentation and the pre-op imaging: x.com/orthobullets/status/20… Do you agree with the treatment? Why or why not? Leave a comment and keep the great conversation going! #orthotwitter Vote on this case for CME: orthobullets.tiny.us/2p8d42z…

As a person with experience, how will widening the pelvis NOT destabilise the SIJts. Surely once you stand up they are going to need a sacral screw or fixation to prevent that moving. Also I would fully expect this to be an exfix, to keep this all together, this is non essential