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VOLUME 6 , ISSUE 1 ( April, 2011 ) > List of Articles

Original Article

Modified hybrid fixator for high-energy Schatzker V and VI tibial plateau fractures

Hisam Muhamad Ariffin, Nidzwani M. Mahdi, Shaharuddin A. Rhani, Azmi Baharudin, Mohamad Hassan Shukur

Keywords : High-energy tibial plateau fractures, Severe soft tissue injury, Hybrid external fixator

Citation Information : Ariffin HM, Mahdi NM, Rhani SA, Baharudin A, Shukur MH. Modified hybrid fixator for high-energy Schatzker V and VI tibial plateau fractures. 2011; 6 (1):21-26.

DOI: 10.1007/s11751-011-0105-4

License: CC BY-NC-SA 4.0

Published Online: 30-04-2011

Copyright Statement:  Copyright © 2011; Jaypee Brothers Medical Publishers (P) Ltd.


High-energy tibial plateau fractures associated with severe soft tissue injury are difficult to manage. The risk of wound complications following open reduction and internal fixation is notably high owing to extensive soft tissue dissection. Alternatively, application of hybrid external fixator minimizes soft tissue dissection and provides adequate fracture stabilization to allow early range of motion and correction of any mal-alignment. With this technique, soft tissue complications particularly surgical site infections are expected to be significantly reduced. This prospective study aims to determine the effectiveness of a modified hybrid external fixator in the management of high-energy tibial plateau fractures. Thirty-three patients with high-energy Schatzker V and VI tibial plateau fracture with severe soft tissue injury precluding formal open reduction were enrolled into the study. The fixator was a construct combining the Ilizarov ring with a monolateral external fixator. The results—bony union, range of motion, and associated complications of the treatment—were assessed. All fractures united within an average time of 14 weeks. Neither loss of reduction nor surgical site wound breakdown/osteomyelitis was noted. Eight patients developed superficial pin track infection and one septic arthritis of the knee joint. Hybrid external fixation is a safe option for complex high-energy tibial plateau fractures by simultaneously providing adequate fracture stabilization and protection of soft tissue healing to achieve bony union. The complication is mainly related to pin tract infection.

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