High energy tibial plateau fractures treated with hybrid fixation: is knee bridging necessary?

This article assesses the necessity of knee bridging in high-energy tibial plateau fractures treated with ring or hybrid frames. One hundred twelve tibial plateau fractures were treated with hybrid fixation. Thirty fractures underwent simple tibial fixation and 82 fractures required provisional extension of the femoral fixation. Mean follow-up was 5 years (range: 28 months to 13 years). Seventy-three percent of the injuries had at least one indication for fixation and 57% had more than one indication for tibiofemoral fixation. The most common indications include comminution, soft-tissue compromise, and ligamentous injuries. The majority of high-energy tibial plateau fractures are associated with such injuries that require knee bridging. Fixed tibiofemoral fixation offers better subjective, clinical, functional, and radiologic results.