Journal of Musculoskeletal Trauma

Dual Plate Fixation Compared with Hybrid External Fixator Application for Complex Tibial Plateau Fractures: Jae Sung Lee, Yong Beom Park, Han Jun Lee; J Korean Fract Soc 2008;21(2):124-129. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.124

Abstract PDF: PURPOSE
To cmpare the clinical results of complex tibial plateau fractures treated by hybrid external fixation and dual plate fixation.
MATERIALS AND METHODS
We studied forty patients with Schatzker type V and VI fractures respectively and selected twenty seven patients who were followed at least one year between January 2000 and December 2005. We evaluated the clinical results in which fourteen fractures with hybrid external fixation were compared with thirteen fractures with dual plate fixation. The clinical results were evaluated according to Knee Society Clinical Rating System and the statistical analysis was performed by Student t-test.
RESULTS
There were no significant differences in terms of bone union time (average union time: dual plate fixation 13.8 weeks, hybrid external fixation 14.2 weeks). The quality of osseous reduction was superior in the fractures with dual plate fixation than those with hybrid external fixation. There were significant differences in functional score (average functional score: dual plate fixation 73, hybrid external fixation 62), but not in average knee score.
CONCLUSION
The hybrid external fixation can be a useful modality for treatment of complex proximal tibial plateau fractures. But the good quality of the fracture reduction by dual plate fixation may be a indicator for favorable prognosis for satisfactory knee function.

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Bicondylar Tibial Plateau Fractures Treated with Hybrid-Ring External Fixator: Chang Wug Oh, Hee Soo Kyung, Joo Chul Ihn, Byung Chul Park, Young Chul Choi; J Korean Soc Fract 2000;13(4):877-883. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.877

PURPOSE
This study was designed to evaluate the indirect reduction or limited internal fixation with hybrid external fixation for bicondylar fractures of proximal tibia. MATERIALS & METHODS: Twenty-two cases (mean age; 49) proximal tibial fractures have been treated, including 7, type V and 15, type VI. After reconstruction of articular surface, the hybrid fixation was applied at the condyle and shaft with or without limited internal fixation by cannulated screw or one-third plate. We permitted early ROM exercise of knee and partial weight-bearing about 4 weeks after operation.
RESULTS
Time to union averaged 15.6 weeeks(range ; 11-20 weeks). There were 4 cases of nonunion including three cases of early bone graft for severe comminution and one infection. Functional scoring revealed 5 excellent, 12 good, 3 fair and 2 poor results. 18 out of 22 cases had good or excellent result in anatomical grading. The mean range of knee motion was 116 degrees(from 4.1 to 120 degrees). In complications, there were two cases of malunion, one deep infection, and one pin-site infection, but soft tissue compromise such as skin necrosis was not happened.
CONCLUSION
The indirect reduction or limited internal fixation with hybrid external fixation for bicondylar fractures of proximal tibia have advantages of anatomic, stable fixation, early mobilization and less soft tissue dissection, so good results of knee function can be accomplished.

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Dual Plate Fixation Compared with Hybrid External Fixator Application for Complex Tibial Plateau Fractures
Jae-Sung Lee, Yong-Beom Park, Han-Jun Lee
Journal of the Korean Fracture Society.2008; 21(2): 124. CrossRef

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Operative Results in AO Type C3 of Tibial Pilon Fracture: Limited Internal Fixation and Hybrid External Fixation: Byeong Yeon Seong, dong Seong Park, seung Jun Park, Sang Wook Kim, Taek Geon Lee; J Korean Soc Fract 1998;11(3):576-584. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.576

Abstract PDF: The intraarticular fractures of the distal tibia has been the most difficult problem due to severe comminution of itself, little bone mass and poor circulation of soft tissue. Recently limited internal fixation with hybrid external fixation has been reported to provide a good clinical results for the severely commnuted or open pilon fractures as a AO type C3. From February 1994 to February 1996, the authors analyzed the clincal and radiological results of 2 year follow-up in 7 cases of the AO type C3 pilon fractures who were treated with combination of limited internal fixation and hybrid externalfixation. 6 cases had good or excellent clinical and radiological results without any serious complications such as skin sloughs, skin infection, malunion and nonunion, but one case had a nonunion who were treated with internal fixation and autogenous iliac bone graft. We believe that the combination of limited internal fixation and hybrid external fixation that does not cross the ankle joint, provides the good clinical results in AO type C3 pilon fractures by early ankle joint motion.

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