Letters to the Editor   |    
Fixation of Type-C Tibial Plafond Fractures
H.L. Nag, MS1
1 Department of OrthopaedicsAll India Institute of Medical SciencesAnsari Nagar, New Delhi 110029Indiahlnag@hotmail.com
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The author did not receive grants or outside funding in support of the research or preparation of this manuscript. The author did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the author is affiliated or associated.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2004 Feb 01;86(2):431-a-432
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To The Editor:I read with interest the article entitled "Combined Percutaneous Internal and External Fixation of Type-C Tibial Plafond Fractures. A Review of Twenty-two Cases" (2002;84[Suppl 2]:109-15), by Manca et al. The method of reduction of small articular fragments with use of curved 3-mm Kirschner wire inserted through a proximal hole and under image intensifier control was innovative and commendable. I am interested to know whether the reduction of the fracture could have been better maintained with multiplane Ilizarov fixation instead of the monoplane Orthofix hybrid that was used. Perhaps this would have prevented the kind of malunion shown in one of the illustrations (Fig. 10-D). Also, was there any difference in the results of the cases in which the operation was delayed between eight and sixteen days and those of the cases in which the operation was performed immediately? Finally, implants around the ankle joint usually are supposed to be removed as soon as their purpose is over. I wonder why some of the implants were not removed even as long as seven years after the operation (Fig. 9-C).
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