Dealing with soft tissue compromised in tibial plateau fractures by using a hybrid external fixation
Seti Aji Hadinoto1, Tito Sumarwoto1, Tangkas Sibarani2
1Department of Orthopaedic and Traumatology, Medical Faculty of Sebelas Maret University, Surakarta, Indonesia; Consultant Upper Limb and Microsurgery Orthopaedic Surgeon, Prof. Dr. R. Soeharso Orthopaedic Hospital, Surakarta, Indonesia.
Introduction And Importance:
Tibial plateau fractures are often accompanied by soft tissue compromise, especially in Schatzker 5 and 6, caused by high-energy trauma. In this situation, more careful consideration is needed. A rush decision will result in morbidity, bad postoperative wounds, and infections resulting in dehiscence.
Case Presentation:
We have three patients with the tibial plateau. In the first case, ORIF was still performed on the fracture with soft tissue compromised. The patient was found to have wound dehiscence resulting in an implant-exposed bone. In the subsequent two cases, Patients with tibial plateau Schatzker 6 fractures also showed blisters around their injured knees. We performed hybrid external fixation. Screwing fixation was performed to obtain compression. Kirschner wire 2.2 formed a raft configuration attached to the semicircular frame and uniplanar external fixation to support the tibial plateau.
Clinical Discussion:
A hybrid external fixation is an excellent option for treating tibia plateau fractures with compromised soft tissue. It can achieve early fracture fixation while avoiding soft tissue problems; thus, the patients can start early rehabilitation.
Conclusion:
A hybrid external fixation can be applied to tibial plateau fractures with soft tissue compromised without waiting for subsiding and has satisfactory clinical and radiological outcomes. The author also explains this case report's hybrid external fixation technique.
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