FUNCTIONAL OUTCOME OF COMPLEX PROXIMAL TIBIA FRACTURE (SCHATZKER TYPE 5 AND 6) MANAGED WITH HYBRID EXTERNAL FIXATOR VERSUS LOCKING PLATE

Abstract

Background: Complex proximal tibia fractures, particularly Schatzker types V and VI, are challenging injuries due to articular involvement, instability, and associated soft-tissue damage. Hybrid external fixation and locking plate fixation are commonly used surgical options, but their functional outcomes may differ. Objectives: To compare the functional outcome of hybrid external fixator versus locking plate in the treatment of complex proximal tibia fractures (Schatzker type V and VI). Study Design & Setting: This study was conducted in the Department of Orthopaedics, PGMI/Shaikh Zayed Hospital, Lahore from 1st December 2025 to 1st May 2026. Methodology: A total of 222 patients aged 18–60 years with isolated Schatzker type V or VI proximal tibia fractures were enrolled and randomly allocated into two equal groups. Group A (n=111) was treated with a hybrid external fixator, while Group B (n=111) underwent locking plate fixation. Functional outcome was assessed after 12 weeks using Rasmussen’s functional grading. A score of 27–30 was considered an excellent functional outcome. Data were analyzed using SPSS version 26, and a p-value <0.05 was considered statistically significant. Results: The mean age was 38.74±11.26 years in Group A and 39.51±10.84 years in Group B. Excellent functional outcome was achieved in 19 (17.1%) patients treated with a hybrid external fixator compared with 34 (30.6%) patients treated with a locking plate. The difference between the groups was statistically significant (p=0.018). Conclusion: Locking plate fixation resulted in a significantly higher frequency of excellent functional outcomes than hybrid external fixation in patients with complex proximal tibia fractures.