A prospective and retrospective study for definitive management of fracture tibial condyle with compromised skin with hybrid fixator

Abstract

Introduction: Proximal tibial fractures present a broad spectrum of soft tissue and bony injury patterns. Fractures of the proximal tibia are caused by high-energy mechanisms, a careful evaluation of the entire patient must be done. The Hybrid External Fixator combines the advantages of the monolateral pin fixators and the circular Ilizarov wire fixators. The tensioned wires provide improved fixation in the small cancellous fragment, whereas the pin fixators give adequate stability to the diaphyseal fragment. It also allows immediate mobilization of the joints and early weight bearing. Materials and methods: This study was conducted on 60 patients after satisfying inclusion criteria with fracture tibial condyle with compromised skin definitively managed with a hybrid fixator. Results: The present study consists of 60 cases of proximal metaphyseal fracture of the tibia. 2 patients were lost to follow up and not included in the analysis. In all cases, fractures were fixed using the hybrid fixator. The proximal tibia fracture united with an average of 15.2 weeks (range 13-18weeks). There were one case of delayed union, which united with PRP (platelets rich plasma). There were 2 nonunion, which was again operated with proximal tibia locking plate and united. 2 cases lost from follow-up. The fracture of the proximal tibia united with an average of 15.2 weeks (range 13-18weeks). There were one cases of delayed union, which united with PRP (platelets rich plasma). There were 2 nonunion, which was again operated with proximal tibia locking plate and united. Conclusion: 60 patients with fractures of the proximal tibial periarticular fracture, all patients were operated on within 7 days had undergone closed reduction and application of the hybrid external fixator. This method limits further damage to the already compromised soft tissue. Its greatest advantage is in open fractures, where wounds can be left open. It is also effective in extra articular fractures occurring within 5cm of the joint. When encountered with the reconstruct able tibial metaphyseal fracture, those with comminution or poor bone stock, closed reduction and Hybrid External Fixator satisfies the goals of fracture union and soft tissue healing.

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