Evaluation of the Outcome of Proximal Tibial Fractures Treated with Joshi External Stabilization System

Background: High-energy proximal tibial fractures, particularly Schatzker types V and VI, present complex challenges due to associated soft tissue injuries. Conventional internal fixation may be contraindicated. The Joshi External Stabilization System (JESS) offers a minimally invasive alternative with soft tissue preservation. Objective: To evaluate the functional and radiological outcomes of proximal tibial fractures managed using JESS. Materials and Methods: A prospective observational study was conducted on 25 patients with proximal tibial fractures (Schatzker types III–VI) treated with JESS at a tertiary care center in North India. Rasmussen’s Functional and Radiological Scores were used at 6, 12, 18, and 24 weeks postoperatively. Complication rates, time to mobilization, and weight-bearing status were also documented. Results: Mean patient age was 43.4 years; 96% were male. Schatzker type VI fractures predominated (60%). At 24 weeks, 80% achieved good-to-excellent functional outcomes, and 92% had good-to-excellent radiological scores. Complications included pin tract infection (16%) and one case of nonunion (4%). Conclusion: JESS is a viable and effective alternative for treating complex proximal tibial fractures, especially in cases with soft tissue compromise. It allows early mobilization and delivers favorable functional and radiological outcomes with minimal complications.