Hybrid External Fixation in the Treatment of Periarticular Fractures of Tibia

Park, Tae Woo; Cho, Sung Do; Kim, Jung Jae; Cho, Yong Sun; Kim, Bum Soo; Kim, Gi Bong; Kim, Key Young

Abstract

The authors constructed a simple hybrid frame by combining AO tubular and llizarov ring external fixator, using a modified AO single adjustable clamp. From 1997 Jan. to 1998 Apr. 19, periarticular fractures of the tibia were treated with hybrid external fixator. The clinical results using this frame were then analyzed. Of the 19 cases, there were 11 proximal and 8 distal periarticular fractures of the tibia. Open fractures were 5 cases in proximal and 2 cases in distal tibial fractures. All fractures were classified according to the AO classification. There were 1 A2, 4 A3, 1 C1, 5 C2 proximal and 1 A2, 4 A3, 1 C1, 2 C2 distal periarticular fractures. The mean bony union time was 13 wks (range 8-36 wks) and the mean length of time in the external fixator was 12 wks (range 8-36 wks). At last follow up, the MPTA of the proximal tibia was 87.2+/-0.8 and the LDTA of the distal tibia was 88.6+/-1.1. The mean articular depression of the intra-articular fractures was 1 mm. Complications were intermittent pin drainage in 7 patients (26.3%), deep infection in 1 patient (5.3%), delayed union in 3 patients (15.8%) and nonunion in 1 patient (5.3%). In conclusion, hybrid external fixation is a good treatment option for periarticular fractures of the tibia because of its simplicity, versatility, sufficient stability to allow early joint motion, little further soft tissue damage, and so on.