Provisional Dynamic Hinged External Fixation Enables Arthroscopy-Assisted Circular Frame Reconstruction of Complex
Ilan Y Mitchnik1,2, Uri Hazan1,2, Mohammad Shalabi1,2
1Department of Orthopaedic Surgery Shamir Medical Center Beer Yaakov Israel.
Arthroscopy, Sports Medicine, and Rehabilitation
|July 1, 2026
Summary
A dynamic external fixator aids arthroscopic reduction of complex tibial plateau fractures, allowing knee motion and good outcomes. This technique shows promising results for complex fractures.
Area of Science:
- Orthopedic surgery
- Trauma surgery
- Arthroscopy
Background:
- Complex tibial plateau fractures require precise reduction for optimal outcomes.
- Traditional methods may limit joint mobility and surgical access.
Purpose of the Study:
- To evaluate the surgical technique and early outcomes of using a provisional dynamic external fixator.
- To assess its role in facilitating arthroscopic-assisted reduction of complex tibial plateau fractures.
Main Methods:
- Retrospective case series of Schatzker IV-VI fractures treated with provisional dynamic external fixation and arthroscopy-assisted fixation.
- Minimum 1-year follow-up assessing perioperative metrics, radiographic outcomes, and complications.
Main Results:
- Provisional fixation allowed knee flexion during definitive surgery.
- Low operative time and blood loss were observed.
- At 1 year, good radiographic alignment, near-full range of motion (0-115°), and union were achieved.
- Infection rate was 45% (mostly pin-site), with no revision surgeries.
Conclusions:
- Provisional dynamic external fixation is a viable technique for complex tibial plateau fractures.
- It facilitates arthroscopic reduction while preserving knee motion.
- Early results show good radiographic and functional outcomes with manageable complications.
