Limited internal fixation with hybrid external fixator for distal tibial fracture / 中华骨科杂志

ABSTRACT

Objective To assess the clinical value of hybrid external fixator combined with limited internal fixation for distal tibial fracture.Methods 22 patients with distal tibial fracture were treated with hybrid external fixator and limited internal fixation from March 2002 to January 2005.In those cases,17 patients were male and 5 patients were female,their age was from 20 to 48 years old,with an averge of 33 years old,all fracture sites were not beyond the ankle joint for 5 cm.Among those cases,18 patients were intraarticular fracture and between them 4 patients belong to Ruedi typeⅡ,14 patients belong to Ruedi type Ⅲ.4 patients were extraarticular fracture.18 patients were close injury and of them 16 patients belong to modified Tscherne typeⅡ,2 patients belong to modified Tscherne typeⅢ.4 patients were open fracture,2 patients belong to GustiloⅡand 2 patients belong to Gustilo Ⅲ.Displaced articular fragments were fixed with cannulated lag screws or Kischner wires,the reduction of extraarticular fracture by adjusting external fixator to acquire.Results All patients were followed-up from 8 to 28 months,mean 18 months and average heal time was 3.2 months.Using Tornetta criteria,excellent 10,good 5,fair 3,with 83% excellent and good rate for intraarticular fracture.Excellent 3,good 1,for extraarticular fracture.There were 20 patients with wound primary healing,2 patients delayed healing and they all were open fracture.Complications included 10? anterior angled malunion in 1 case,and pin tract infection in 2 cases.Conclusion Using this metheod treated distal tibial fracture can reduce soft tissue injury,can obviously reduce the wound infectious rate and admit early motion of ankle joint,so it is beneficial to early restore the ankle joint's function.