Hybrid Ring External Fixation in the Treatment of Complex Tibial Plateau Fractures

The treatment of high-energy bicondylar tibial plateau fractures remains challenging. These injuries are often complicated not only by the severe bony injury but also by the accompanying soft tissue injury. The use of hybrid ring external fixation, with or without limited internal fixation, to treat these injuries evolved from the desire to minimize the additional surgical insult to soft tissues already traumatized by the injury. Although it can be technically demanding, this technique offers the orthopaedic surgeon an additional way to treat complex fractures through minimal additional soft tissue trauma, while meeting the treatment goals of stable fixation, restoration of joint congruity and limb alignment, limited complications, early range of motion, and good functional outcomes.