FUNCTIONAL OUTCOME OF HYBRID EXTERNAL FIXATOR IN COMPOUND COMMINUTED TIBIAL FRACTURES

Abstract

AIM OF THE STUDY The aim of the study is to evaluate the functional outcome of Compound comminuted tibial fractures using hybrid external fixator . Patients were retrospectively evaluated for functional outcome in terms of early weight bearing, range of motion, fracture union and soft tissue healing .MATERIALS AND METHODS The study           period was 28 months between september 2013 and january 2016. During the study period , Four patients with compound comminuted tibial fractures were treated, using a Hybrid  external fixator in the Department of Orthopedics . The             average age of the patients was 47 years. The fractures  classified according to AO classification and Gustilo and Anderson classification . The patients were initially treated with wound debridement as per AO guidelines and                immobilized with posterior splint and they were electively treated with a hybrid external fixator . Prophylactically the patients were on intravenous antibiotics for 2 weeks and weight bearing started after two weeks . None of them needed soft tissue cover. RESULTS The patients were   followed up periodically at regular intervals for wound healing and fracture union. At the final follow up , patients were  evaluated based on clinical and radiographic findings. Functional outcome was graded according to Klemm and Borner scoring system. One patient had superficial pin site infection which was managed with oral antibiotics . The   results were excellent in 1 patient and good in 3  patients. CONCLUSION Hybrid external fixator can be used with advantage for treatment of complex compound tibial fractures and fractures associated with soft tissue   compromise . This method enables us to stabilize fractures of the tibial metaphysis as well as diaphyseal fractures as a definitive fixation allowing early weight bearing and good range of motion .