Hybrid external fixation for tibial plateau fractures: Clinical and biomechanical correlation

The biomechanical data support the use of tensioned wire fixation to stabilize complex fractures of the proximal tibia. The authors have shown that the stability of a four-wire construct is comparable to the gold standard of dual plating internal fixation techniques. Using these techniques many recent investigators have demonstrated improved clinical results, with average knee scores (Knee Society Rating System) for most patients ranging from 85 to 90. More important is that these studies continue to show decreases in the rates of major wound complications or residual osteomyelitis; these decreases had occurred with traditional ORIF techniques despite the fact that approximately one third of cases in these series were open injuries. With these data available, small wire hybrid fixation positioned in a stable frame configuration is an additional tool that should be considered for complex proximal tibial injury.