Role of Hybrid Fixator in Proximal Tibial Fractures: A Prospective Evaluation of Clinical and Radiological Outcomes

Background Management of complex proximal tibial fractures is challenging due to periarticular comminution and associated soft-tissue compromise. Hybrid external fixation has been proposed as an alternative to internal fixation in such cases. This study aimed to evaluate the functional and radiological outcomes of hybrid external fixation in proximal tibial fractures. Methods This was a prospective observational study conducted at a tertiary care teaching hospital over one year. Thirty adult patients with periarticular or intra-articular proximal tibial fractures were treated using hybrid external fixation. Patients were followed up for a mean duration of six months. Functional and radiological outcomes were assessed at final follow-up using Rasmussen's functional and radiological scoring systems. Descriptive statistical analysis was performed. Results Thirty patients with complex proximal tibial fractures were included. The mean age was 48.2 ± 11.86 years, with a male predominance (63.33%). Road traffic accidents accounted for 83.33% of injuries, and most fractures were Schatzker type V (36.67%) or VI (43.33%). The mean injury-to-surgery interval was 2.7 ± 1.1 days, and postoperative weight bearing was initiated at 8.68 ± 1.26 weeks. The mean Rasmussen functional score was 26.37 ± 3.3, with excellent-to-good functional outcomes in 83.34% of patients. Excellent-to-good radiological outcomes were achieved in 86.67%. Pin-tract infection was the most common complication (16.67%), while 63.33% of patients had no complications. Conclusion Hybrid external fixation resulted in acceptable short-term functional and radiological outcomes in complex proximal tibial fractures, particularly following high-energy trauma with soft-tissue compromise. The procedure demonstrated a manageable complication profile; however, conclusions are limited by the small sample size, descriptive design, and short follow-up. Larger comparative studies are required to better define its role in this fracture subset.