Review of Functional Outcome in Management of Proximal Tibial Fracture with Ring Fixator vs Hybrid External Fixator

Tibial plateau fractures are caused by high-energy trauma and are often associated with soft tissue injuries, which complicates the surgical management. ORIF and plating, even though conventionally done for proximal tibia fractures and convenient for the patient, are not free from complications. Ilizarov ring fixators come to the rescue in such cases. However, all centers and all surgeons are not equipped to treat tibial plateau fractures with the Ilizarov fixator, and a hybrid fixator may be a good option. The purpose of this narrative review is to evaluate and compare the outcomes of proximal tibia fractures treated by hybrid and Ilizarov fixators in the existing literature.

Literature search was done using the keywords, one author gathering the studies mentioning the proximal tibia fracture fixation by hybrid fixators and another by the ring fixator. All parameters noted in the studies were compiled and compared.

Eleven studies mention fixation with hybrid fixators and twelve studies with the Ilizarov fixators. Type and duration of study, total patient numbers and average age, gender distribution, fracture classification type mentioned, percentage of open fractures, mechanism of injury, time from injury to surgery, type of construct, post-operative protocol in terms of knee range of motion and weight-bearing total frame time, union time, maximum follow-up, scoring system used, final range of movement at knee and types of complications were noted and compared.

Hybrid and Ilizarov fixators are viable options for the treatment of tibial plateau fractures, especially with bad soft tissue status and open fractures with similar union times and range of motions achieved despite differing post-operative rehabilitation protocols.