Digital six-axis external frame assisted unilateral external fixator for treatment of tibial shaft fractures: achieving anatomical reduction and stabilization

• The digital six-axis external fixator (Qiao's frame) provides more precise anatomical reduction, while the unilateral external fixator reduces the bulk and complexity of traditional ring external fixators, lowering nursing burden. • Using CT-based digital six-axis external fixator enables closed reduction with a reduced incidence of pin tract complications, demonstrating the safety of the Qiao's frame-assisted unilateral external fixator technique. • The technique further validates comprehensive clinical benefits including operative time, medical cost, and patient experience, and is recommended for complex fractures such as tibial shaft fractures combined with femoral shaft fractures. • The Qiao's frame-assisted unilateral external fixator technique offers a minimally invasive and effective innovative treatment option for closed and open tibial shaft fractures; future research should further validate its comprehensive advantages and expand its applicability.