HYBRID EXTERNAL FIXATION IN THE TREATMENT OF TIBIAL PLAFOND FRACTURES

From 1992 to 1994, 37 fractures (36 patients) were treated with hybrid external fixation for tibial plafond or distal tibial fractures. The fractures were classified according to the AO classification: A1 (3), A2 (3), A3 (4), C1 (6), C2 (12), C3 (9). There were 11 open injuries, and in 27 patients (75%) the mechanism of injury was high energy traum a. Results were evaluated based on a subjective and objective rating s ystem. Thirty-four patients were available for follow-up at an average of 15.2 months. AII fractures in this series united with an average t ime to healing of 4.6 months. Anatomic or good alignment was obtained in all but 1 fracture. There were 12 excellent, 9 good, 7 fair, and 6 poor results. In the 18 C2 and C3 fractures there were 8 good to excel lent, 4 fair, and 6 poor results. Degenerative changes were seen on fo llowup radiographs in 3 of these patients. Complications occurred in 1 2 patients (35%) and included 1 skin slough, 5 pin tract infections, 3 deep infections, 3 nonunions, and 3 loss of reductions necessitating frame revision. This method yielded results comparable with previous s tudies cvhile decreasing the number of complications resulting from tr eatment.