Abstract
Introduction: The Staffordshire Orthopaedic Reduction Machine (STORM) was developed to assist in the reduction of tibial shaft fractures prior to the application of an external fixator. Its use has now been extended to fractures of the tibial plateau and plafond, where it has been utilised to gain and hold a good reduction prior to the application of various internal and external fixation techniques.
Methods: The STORM was used sterile within the operative field on a standard radiolucent operating table. It was applied with two tensioned 2 mm wires: the distal through the calcaneum; the proximal through the proximal tibia for shaft and pilon fractures, and through the distal femur for plateau fractures.
Controlled traction was applied through these two wires. Torsion was independently corrected and locked. Translation and angulation was corrected using two translation arms each applied to the tibia with a single unicortical screw. The STORM was removed at the end of each operation.
Results: The STORM was used in 241 cases.
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Pilon (n=42): bridging hinge 23 (t [mean operation time in minutes]=102.9), percutaneous plate 10 (t=131.4), ring fixator 5 (t=140), screws and fibula plate 3 (t=77), other 2.
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Plateau (n=23): ring fixator 11 (t=129.7), LISS plate 8 (t=98.6 mins), monolateral Garches fixator 3 (t=64.4), screws only 1 (t=15).
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Shaft (n=176): monolateral fixator 138 (t=69.1), ring fixator 37 (t=131.2), nail 1 (t=65).
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Ilizarov rings up to 200 mm were accommodated.
Discussion: The STORM is a safe device for reliable reduction of tibial plateau, shaft and pilon fractures which allows good access for internal or external fixation. No significant complications attributable to the use of the current design of the STORM were encountered.
Correspondence should be addressed to BLRS c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
