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TRAUMATOLOGY
Year : 2006  |  Volume : 40  |  Issue : 3  |  Page : 177-179

Management of periarticular fractures of long bones of the lower extremity by hybrid external fixation


Department of Orthopaedic Surgery and Traumatology, Madras Medical College, Government General Hospital, Chennai, India

Correspondence Address:
Mayil Vahanan Natarajan
Department of Orthopaedic Surgery and Traumatology, Madras Medical College, Government General Hospital, Chennai
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5413.34487

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Background : Management of periarticular fractures is associated with many complications. Hybrid fixators allows for early partial weight bearing and range of motion exercises at adjoining joints. Furthermore, it promotes callous formation by continuous axial micro movements in the fixation frame. Methods : We have prospectively analyzed the results of hybrid external fixation in the management of periarticular fractures of long bones of the lower extremity in 20 patients accounting for 22 limbs. We treated 19 fractures (18 compound and 1 closed) and three fracture nonunions with this method. The mean age of the patients was 36.5 years. In 12 patients hybrid fixation was the primary procedure while in 8 patients hybrid fixation was done following initial emergency AO Uniplanar external fixation. Fourteen patients required subsequent surgeries such as bone grafting and soft tissue cover. Results : The mean follow up of our patients was 13.2 months (5 - 25 months). We achieved excellent results in 10 fractures, good in 4 fractures, fair in 3 fractures and poor results in 3 fractures. Two patients were lost to follow up. Bony union was achieved in 18 of the fractures. A short-term acceptable result was achieved in 17 cases. Conclusion : Hybrid external fixation is a very effective and useful treatment modality in the management of fractures close to a joint providing excellent to good results. It combines the advantages of both Ilizarov and AO external fixators. It is minimally invasive, modular and yet efficient in promoting massive new proliferative callus formation at the fracture site.


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