Hybrid external fixation in periarticular tibial fractures. Good final outcome in 56 patients

Out of 65 patients with periarticular fractures of the tibia treated by use of hybrid external fixation (a combination of indigenously manufactured version of ring and AO tubular fixator) from February 1997 to October 2003, 56 cases were taken up for this study with a minimum follow-up of 12 months. The injury was due to a high-velocity motor vehicle accident in 49 and a fall in 7 patients. Thirty five were tibial plateau fractures and 21 were distal tibial plafond fractures. Forty eight were compound fractures and eight were closed. They were treated by debridement (48 compound) and hybrid external fixator (n = 56). All the patients were assessed clinically and radiographically for an average follow-up of 42.5 months (range: 12 to 67). In tibial plateau fractures (n = 35), the final outcome was good to excellent in 30, fair in 2 and poor in 3. In tibial plafond fractures (n = 21), results were good to excellent in 16, fair in 3 and poor in 2. We recommend the use of hybrid external fixator for periarticular tibial fractures occurring due to high-energy trauma. In addition, rates of complications as seen with other modalities of fixation are greatly reduced. It facilitates adequate care of associated soft tissue injuries.