COMBINATION OF ILIZAROV RING FIXATOR WITH THE UNILATERAL AO-ASIF FIXATOR - FIRST CLINICAL-RESULTS WITH THE HYBRID CONFIGURATION

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.