Introduction: The Hybrid External Fixator combines the advantages of the monolateral pin fixators and the circular Ilizarov wire fixators. Principle of early motion has been touted as the functional savior of major intra articular injuries in application of hybrid external fixation. Materials & Methodology: 48 patients were considered for the study with tibial fractures admitted in Mamata General Hospital from May 2011 to May 2013. Results: The union and functional outcome of hybrid external fixator in simple and complex proximal and distal metaphyseal fractures of tibia in adults was evaluated at our centre. The fractures of the proximal tibia united with an average of 13.3 weeks (12 - 16 weeks). The fractures of the distal tibia united with an average of 14.42 weeks (13 - 22 weeks) with minimal complications. Conclusion: Our study shows high satisfaction rate after fixation, provides adequate stability and allows early motion of the joint. It is also effective in extra articular fractures occurring within 5 cm of the joint as the IM nails often do not provide enough stability and plating requires extensive soft tissue dissection.
References
[1]
Salter, R.B. and Ogilvie-Harris, D.J. (1979) Healing of Intra-Articular Fractures with Continuous Passive Motion. AAOS Instructional Course Lectures, 28, 102-117.
[2]
Sirkin, M. and Sanders, R. (2001) The Treatment of Pilon Fractures. Clinical Orthopaedics, 32, 91-102.
[3]
French, B. and Tornetta, P. (2000) Hybrid External Fixation of Tibial Pilon Fractures. Foot and Ankle Clinics, 5, 2000.
[4]
Apley, A.G. (1979) Fractures of the Tibial Plateau. Orthopedic Clinics of North America, 10, 61-74.
[5]
Schatzker, J., McBroom, R. and Bruce, D. (1979) The Tibial Plateau Fracture: The Torontoexperience (1968-1975). Clinical Orthopaedics, 138, 94-104.
[6]
Schatzker, J. (1988) Fractures of the Tibial Plateau. In: Schatzker, J. and Tile, M. (1988) The Rationale of Operative Orthopaedic Care, Springer-Verlag, New York, 279-295.
[7]
Yang, L., Saleh, M. and Nayagam (2000) The Effect of Different Wire and Screw Combinations on the Stiffness of Hybrid External Fixator. Proceedings of the Institution of Mechanical Engineers, 214, 669-676. http://dx.doi.org/10.1243/0954411001535697
[8]
Mallik, A.R., Covall, D.J. and Whitelaw, G.P. (1992) Internal versus External Fixation of Bicondylar Tibial Plateau Fractures. Orthopedic Reviews, 21, 1433-1436.
[9]
Young, M.J. and Barrack, R.L. (1994) Complications of Internal Fixation of Tibial Plateau Fractures. Orthopedic Reviews, 23, 149-154.
[10]
Dillin, L. and Slabaugh, P. (1986) Delayed Wound Healing, Infection, and Non Union Following Open Reduction and Internal Fixation of Tibial Plafond Fractures. Journal of Trauma, 26, 1116-1119. http://dx.doi.org/10.1097/00005373-198612000-00011
[11]
Helfet, D.L., Koval, K., Pappas, J., Sanders, R.W. and Dipasquale, T. (1994) Intraarticular “Pilon” Fracture of the Tibia. Clinical Orthopaedics, 298, 221-228.
[12]
Barbieri, R., Scbenk, R., Koval, K., Aurori, K. and Aurori, B. (1996) Hybrid External Fixation in the Treatment of Tibial Plafond Fractures. Clinical Orthopaedics, 332, 16-22. http://dx.doi.org/10.1097/00003086-199611000-00004
[13]
Gaudinez, R.F. and Mallikar, S.M. (1996) Hybrid External Fixation in Tibial Plafond Fractures. Clinical Orthopaedics, 329, 223-232. http://dx.doi.org/10.1097/00003086-199608000-00028
[14]
Anglen, J.O. (1999) Early Outcome of Hybrid External Fixator for the Fractures of Distal Tibia. Journal of Orthopaedic Trauma, 13, 92-97. http://dx.doi.org/10.1097/00005131-199902000-00004
[15]
Yang, M., Nayagam, S. and Saleh, M. (2003) Stiff-ness Characteristics and Interfragmentary Displacement with Different Hybrid External Fixators. Clinical Biomechanics (Bristol, Avon), 18, 166-172. http://dx.doi.org/10.1016/S0268-0033(02)00175-4
[16]
Piper, K.J., Won, H.Y. and Ellis, A.M. (2005) Hybrid External Fixation in Complex Tibial Plateau and Plafond Fractures: An Australian Audit of Outcome. Injury, 36, 178-184.
[17]
Aggarwal, A.K. and Nagi, O.N. (2006) Hybrid External Fixation in Periarticular Tibial Fractures. Good Final Outcome in 56 Patients. Acta Orthopaedica Belgica, 72, 434-440.
