A prospective study on the management of proximal tibia fractures with hybrid external fixation

Background: Fractures of the proximal third of the tibia commonly result from high-velocity trauma, particularly road traffic accidents, and are often associated with significant soft-tissue injury. Their management remains challenging despite the availability of multiple treatment options, largely due to complications such as infection, delayed union, and non-union. Hybrid external fixation offers a minimally invasive alternative that provides stable periarticular fragment compression, preserves fracture hematoma, facilitates soft-tissue care in compound injuries, allows early joint mobilization and weight bearing, and enables earlier implant removal compared to many conventional surgical methods. Aims and Objectives: (1) To study the functional outcome of proximal tibia fractures with hybrid external fixation. (2) To assess fracture union, soft-tissue healing, and knee joint mobility following treatment. Materials and Methods: Twenty-nine patients with proximal tibia fractures were admitted to Chigateri General Hospital and Bapuji Hospital attached to J.J.M Medical College, Davangere, in the period of September 2016 to April 2019. Results: All fractures achieved union, with a mean healing time of 14.6 weeks. Complications included pin-tract infection in 10% of cases, post-operative knee pain in 24%, knee stiffness in 7%, delayed union in 4%, and malunion in 10%. Based on the Lysholm knee scoring scale, functional outcomes were excellent in 17%, good in 69%, and fair in 14% of patients. Conclusion: Hybrid external fixation provides stable, minimally invasive management of proximal tibial fractures, promoting soft-tissue preservation, early mobilization, and reduced immobilization-related complications. It is particularly effective for compound and comminuted fractures, with favorable functional outcomes and low complication rates.