Treatment of complex fractures of the proximal tibia by hybrid external fixation and internal fixation / 中华骨科杂志

ABSTRACT

Objective To treat complex fractures of the proximal tibia with the hybrid external fixation and internal fixation and to evaluate their efficiency. Methods During January 2000 to January 2005, 69 patients with complex proximal tibia fractures received operation in our hospital, which included Schatzker types Ⅳ(17 cases), Ⅴ(14 cases) and Ⅵ(9 cases) and AO A3 type 27 cases, and 2 amputation. The average age was 39 years(range from 18 to 74 years). Among them, 19 open fractures and 21 closed fractures were operated with hybrid external skeleton fixation(HESF) combined limited internal fixation, the others were treated by open reduction and internal fixation (ORIF). Results All the patients were followed from 6 months to 5 years(mean, 25 months), in the HESF group the average time of operation was 2.66 h, the bleeding in operation was 170.50 ml, while ORIF group was 3.33 h and 285.19 ml, the amount healing time of HESF group was 16.40 weeks, while the ORIF groups was 12.37 weeks; there were no deep infectious and skin necrosis patients in the HESF group. According to the HSS score system, there were excellent 31, good 5, fair 3 and bad 1 case, the rate of excellent and good was 90%. In the ORIF group, there were 1 deep infectious and 2 skin necrosis patients, 6 cases were malunion, 2 cases were nonunion. There were excellent 5, good 12, fair 7, bad 3 cases, the rate of excellent and good was 63%; and there were significantly difference between the two groups(u=219, P