Hybrid external fixation in the treatment of tibial plafond fractures

From 1992 to 1994, 37 fractures (36 patients) were treated with hybrid external fixation for tibial plafond or distal tibial fractures. The fractures were classified according to the AO classification: A1 (3), A2 (3), A3 (4), C1 (6), C2 (12), C3 (9). There were 11 open injuries, and in 27 patients (75%) the mechanism of injury was high energy trauma. Results were evaluated based on a subjective and objective rating system. Thirty-four patients were available for followup at an average of 15.2 months. All fractures in this series united with an average time to healing of 4.6 months. Anatomic or good alignment was obtained in all but 1 fracture. There were 12 excellent, 9 good, 7 fair, and 6 poor results. In the 18 C2 and C3 fractures there were 8 good to excellent, 4 fair, and 6 poor results. Degenerative changes were seen on followup radiographs in 4 of these patients. Complications occurred in 12 patients (35%) and included 1 skin slough, 5 pin tract infections, 3 deep infections, 3 nonunions, and 3 loss of reductions necessitating frame revision. This method yielded results comparable with previous studies while decreasing the number of complications resulting from treatment.