Abstract: Introduction: The difficulty in treating the fracture of distal tibial metaphysis is exemplified by orthopaedists, who in the first half of 20
th century, believed the injuries were so severe and operative repair was fraught with so many complications that the fracture was deemed not amenable for surgical reconstruction. Since there was no definitive protocol for the treatment of such fractures, the Hybrid External Fixator seemed suitable for such fractures as they combine the advantages of monolateral and circular fixation. Tensioned wires provide improved fixation in small fragments and osteoporotic bone. It allows early weight bearing and movement of ankle at all times.
Materials and Methods: Twenty five patients with distal tibial metaphyseal fractures were studied from June 2016 to July 2018 in our institution and followed up for a period of 6-10 months.
Results: All the fractures consolidated with average of 13 and weeks the fixators were removed. All the studied fractures resulted in good union. 1 of the 3 compound fractures and 2 of the 10 simple fractures developed pin tract infections which were suppressed using antibiotics. 6 patients had ankle stiffness from 20-90% of total ankle movement. This was probably due to the patient incompliance to the physiotherapy regimen. 1 case had a malunion with an anterior angulation of 5 degrees but had a good ankle function. At 6 months, results were based on objective and subjective parameters by Ovadia and Beals. 6 (48%) patients had excellent outcome 3 (23%) had good, 3 (23%) had fair and 1 (6%) patient had a poor outcome.
Conclusion: Hybrid external fixator is simple, rapid and straightforward application, reduced surgical time, minimally invasive and adjustable. It has negligible complications and resulted in excellent results for this type of fractures.
