TRU-2K.101-HP-11
COMPLEX PROXIMAL TIBIAL FRACTURES-IS THE HYBRID EXTERNAL FIXATOR STILL RELEVANT?
Abstract
Objective: To evaluate the combination of minimal osteosynthesis and circular wire external fixation as viable treatment strategy for the complex fractures of the proximal tibia.
Design: Prospective case series.
Methodology: Thirty-eight complex fractures of the proximal tibia were treated with circular wire external fixation with or without limited osteosynthesis
Patients: 31 fractures were closed, and 7 were open. Intervention: Closed indirect reduction by ligamentotaxis and limited internal fixation was attempted in all fractures; limited open reduction and bone grafting was performed in six. The fracture was then neutralized by small wire ring fixator. Main Outcome Measurement: The results were graded according to the Knee Society rating system. Follow-up averaged 24 (range 5-60) months.
Results: 37 (97%) of the fractures united at an average of 14 weeks (range 11-16 ). One fracture did not unite within 9 months and was successfully treated by compressive plating and bone grafting.20 patients had excellent knee scores, 13 had good, 2 fair and 3 poor result. There were no major intraoperative complications, deep infection, septic arthritis. The most common complication was pin track infection, which occurred in 9 patients, but did not change the course of treatment.
Conclusions: The use of circular external fixation offers a less invasive treatment for the complex tibial plateau fractures. The immediate knee movement and early weight bearing grants favorable functional results, with low morbidity.
Design: Prospective case series.
Methodology: Thirty-eight complex fractures of the proximal tibia were treated with circular wire external fixation with or without limited osteosynthesis
Patients: 31 fractures were closed, and 7 were open. Intervention: Closed indirect reduction by ligamentotaxis and limited internal fixation was attempted in all fractures; limited open reduction and bone grafting was performed in six. The fracture was then neutralized by small wire ring fixator. Main Outcome Measurement: The results were graded according to the Knee Society rating system. Follow-up averaged 24 (range 5-60) months.
Results: 37 (97%) of the fractures united at an average of 14 weeks (range 11-16 ). One fracture did not unite within 9 months and was successfully treated by compressive plating and bone grafting.20 patients had excellent knee scores, 13 had good, 2 fair and 3 poor result. There were no major intraoperative complications, deep infection, septic arthritis. The most common complication was pin track infection, which occurred in 9 patients, but did not change the course of treatment.
Conclusions: The use of circular external fixation offers a less invasive treatment for the complex tibial plateau fractures. The immediate knee movement and early weight bearing grants favorable functional results, with low morbidity.
Keywords
Tibial Plateau Freactures, Soft Tissue Injury, Hybrid External Fixator
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