High-energy Tibial plateau fractures treated with ilizarov fixator

Abstract

Introduction/Objective Tibial plateau fractures constitute a significant group of injuries to a major weight-bearing joint. High-energy fractures are difficult to treat, as they entail articular depression, condylar displacement, dissociation of comminuted metaphysis, and closed degloving injuries. The principles of the treatment are anatomical reconstruction of the articular surface, restoration of the anatomical axis, fixation spanning the metaphyseal comminution, and further minimization of soft tissue injury. The aim of this study is to evaluate the clinical outcome of using Ilizarov external fixator in the treatment of high-energy Schatzker IV, V, and VI tibial plateau fractures. Methods This retrospective study was conducted from 2013-2016 on 35 patients (36 fractures) with high-energy tibial plateau fractures classified as Schatzker type IV, V, and VI. The mechanisms of injury were road traffic accident, fall from a height and direct trauma. The fractures were closed in 26 cases and open in 10 cases. All patients were treated with ligamentotaxis and percutaneous fixation using Ilizarov fixator. Functional outcome was determined using the Knee Society Score. Results The mean follow-up period was 20 months. All fractures healed in an average time of 14 weeks. The range of knee flexion after one-year follow-up averaged at 100°. Average Knee Society Score in our study was 77. Conclusion Ilizarov external fixation is a safe and efficient treatment modality for high-energy tibial plateau fractures. It allows reconstruction of the articular surface, stable fixation, early rehabilitation, and care of soft tissue injuries.