Case 2

This is a 14 year old boy who caught his ski in the mesh of a dry ski slope and sustained a tibial fracture with a large anterior butterfly. This was stabilised with the Sheffield Hybrid Fixator. As the fracture line was very steep (81 degrees), additional fixation was required but safe soft tissue corridors contraindicated compressive olive wires, and so the arched wire technique was employed. Although immediate postoperative weightbearing was advised he was afraid to load the leg until one morning around 4 weeks post injury, where he suddenly found himself walking pain free. Since then, he was able to fully weightbearing without discomfort (picture taken at 6 weeks post-op). The arched wires and middle ring were removed for dynamisation at 11 weeks and the frame was removed at 15 weeks. He has had an excellent radiological and functional outcome.