AO external fixator for definitive treatment of an open distal tibia fracture during the COVID-19 pandemic

BACKGROUND: The accepted gold standard for primary treatment of long bone open fractures consists of aggressive debridement, irrigation and temporary external fixation. Removal of the external fixator followed by definite internal fixation is recommended within the first two weeks after the injury to obtain a more stable fixation, alleviate rehabilitation and to avoid pin infection. MATERIALS & METHODS: Here, we report a case of a Gustilo IIIB open tibia fracture with extended soft tissue degloving of the distal tibia. Following removal of the AO external fixator, plate fixation and soft tissue coverage with a free flap, implant loosening occurred warranting a return to external fixation. The patient did not return for follow-up due to a prolonged COVID-19-quarantine and no further treatment was installed. RESULTS & CONCLUSIONS: The patient returned after 6 months with the fractures and soft tissues fully healed. In specific situations, the external fixator may be used as a definitive form of treatment.