Fractures of the proximal quarter of the tibia treated by external fixator

Fractures of the proximal quarter of the tibia present a particular lesion entity likely to raise many therapeutic difficulties because of the vascular and cutaneous complications frequently found and the comminuted nature of the fracture making internal osteosynthesis difficult and a source of complications. All these considerations have led several surgeons to treat these fractures by external fixation. We present a retrospective study of 32 patients with fractures of the proximal quarter of the tibia operated on by external fixation with a minimum follow-up of 12 months. Three types of external fixator were used: the hybrid external fixator (11 cases), the Orthofix external fixator (13 cases) and the Hoffmann external fixator (8 cases).The Lysholm score was used for functional evaluation and we obtained a mean value of 92.63. Exo-fixation is the least invasive and most convenient technique, especially if there are associated integumentary lesions that do not allow internal osteosynthesis.