Hybrid external fixation in treatment of metaphyseal fractures of long bones of the lower extremity

This study was conducted to evaluate the clinical results of metaphyseal fractures of tibia and distal femur after operative treatment by Hybrid External Fixators. A prospective descriptive study from 2004 to2008, conducted in Orthopaedic unit I, Bolan Medical Complex Hospital, Quetta. We have prospectively analyzed the results of Hybrid external fixation in the management of metaphyseal fractures tibia and femur in 21 patients [17 open and 4 closed fractures]. The mean age of the patient was 36.5 years. Age range was 14 yeas to 60 years. Eighteen patients were males and 3 were females. In 19 patients hybrid fixation was the primary procedures while 2 patients were initially dealt by local bone setters. Four patients subsequently required surgeries such as bone grafting and soft tissue cover. The mean follow up our patients was 14.8 months [5-24 months]. We achieved excellent results in 10 fractures, good results in 4 fractures, fair in 4 fractures and poor results in 3 fractures. Bony union was achieved in 18 of the fractures. Hybrid external fixation is an effective and useful treatment modality in the management of fractures close to joints in case of tibia, providing excellent to good results. In ease of distal femur it proved to be less effective. It combines the advantage of both Ilizarov and A.O. external fixators. It is minimally invasive, safe, modular and yet efficient in promoting massive new proliferative callus formation at the fracture site