Mj. Raschke et al., COMBINATION OF ILIZAROV RING FIXATOR WITH THE UNILATERAL AO-ASIF FIXATOR - FIRST CLINICAL-RESULTS WITH THE HYBRID CONFIGURATION, Der Unfallchirurg, 98(12), 1995, pp. 627-632
Ring fixation of the tibia is difficult because of soft tissue transfi
xation and the size and weight of the external fixator. To increase th
e patients comfort K-wire and half-pin fixation are combined in a new
hybrid configuration. The Ilizarov ring fixator with K-wire or Schanz
screw fixation is combined with the unilateral AO fixator. This config
uration has so far been used in 17 cases: in the proximal and intraart
icular tibia in 7 cases, in the distal tibia in 8 cases and in the fem
ur in 2 cases. As experience with the hybrid system widens indications
accepted are metaphyseal and intraarticular fractures of the tibia wi
th severe soft tissue damage, open fractures, segmental defects and fr
actures of the tibia that cannot be nailed. Loosening of the hybrid co
nstruction requiring an additional operative procedure has not occurre
d. The hybrid system is minimally invasive and allows early weight-bea
ring. It has the advantages of less transfixation of the soft tissue,
an easy operative technique and more comfort with higher patient compl
iance, and the options for corrective procedures are the same as with
the conventional Ilizarov technique. Our preliminary first experience
with this system is encouraging; it is especially useful for problemat
ic epi- and metaphyseal fractures with severe soft tissue damage.