Hybrid external fixator in treatment of severely comminuted and open fractures of proximal or distal tibia

Abstract

Objective To evaluate the curative effects of Hybrid external fixator in the treatment of severely comminuted and open fractures of the distal or proximal tibia. Methods From March 2004 to December 2008,we treated 27 patients with severely comminuted and open fractures of the distal or proximal tibia with the Hybrid frame purchased from Orthofix Co.in combination with limited internal fixation if necessary.The internal fixation was done with screws in 6 cases,with absorbable interference serews in 4 and with wire in 3.There were 16 males and 11 females,with an average age of 56.2(13 to 80)years.Accordins to Gustilo-Anderson classification,there were 10 cages of typeⅡ,12 cases of type Ⅲ A and 5 cases ofⅢB.The injuries were mostly caused by traffic accident and fall.Postoperative ankle and/or knee funetions were evaluated by Johner-Wrubs system.Results The patients were followed up for 7 to 58 months(average,27 months).Averagely the patients obtained bone union at 6.7 months and fixator removal at 6 months after operation.The postoperative JohnerWruhs score was excellent in 17 cases.good in 8 and fair in 2.The total exceHent to good rate was 92.6%,without wound infection or complications of nerve and vessel injury.There were only 5 cages of local superficial pin tract infection which responded to oral antibiotics and disinfectants. Conclusion In treatment of severely comminuted and open fractures of the distal or proximal tibia,Hybrid frame fixation may lead to limited invasion,reliable fixation,low rate of complications,and early recovery of joint function. Key words: Tibial fractures; Fractures,comminuted; Fractures,open; External fixators