Functional analysis of Distal tibial fractures treated by Hybrid external fixator

INTRODUCTION: Management of distal tibia fractures remains a challenge. Treatment these fractures pose a therapeutic dilemma weather to give priority to anatomic reduction and articular congruity or to soft tissue healing. AIM: The purpose of this study is to analyse the effectiveness of distal tibial fractures managed by hybrid external fixator . MATERIALS AND METHODS: Prospective study of 25 patients (including 14 compound fractures) with distal tibial fractures treated with Hybrid external fixator. Average age of patients was 43 years. There were 17 type A, 2 type B and 6 type C fractures as per AO classification. All patients were operated under image intensifier fibular fixation with k wire or plating was done in most cases, metaphyseal reduction was obtained and stabilised by olive wires and a ring construct is made in distal fragment, external fixator in the proximal fragment is connected to distal fragment in hybrid mode. Patients were followed up for average period of 12 months. All fractures united except one with an average time to healing of 21.1 weeks. Complications encountered were pin tract infection, delayed union, malunions, tendon impalement. RESULTS: Results were analysed using Ovadia & Beals scoring system, there were 32% excellent, 44% good, 20% fair and 04% poor outcome. Conclusion: Hybrid fixator is an effective method for Open fractures of distal tibia. It provides good access to soft tissue and wound care.The use of hybrid fixator as a definitive procedure for management of distal tibia fractures produces satisfactory functional outcome with limited complications