Clinico - Radiological Results of Tibial Bicondylar Fractures Managed with Ilizarov Technique with or without Minimal Internal Fixation

Abstract

Introduction: Tibial bicondylar fractures are difficult fractures to treat and are usually associated with complications. Materials and methods: Thirty-five patients with Schatzker type V and VI fractures were managed from June 2016 to July 2018 with Ilizarov technique. The mean age of the patients was 46.5 ± 8.9 years, with 28 male and seven female patients. Sixteen patients had Schatzker type V fracture and the remaining had type VI. The functional outcome was assessed by using Modified functional evaluation system by Karlstrom-Olerud and the radiological outcome by Rasmussen's Radiological Score (RRS). Results: All patients achieved radiological union at a mean duration of 16 weeks for type 5 and 17 weeks for type 6 however, full weight-bearing was allowed at a mean of 18 weeks (14-22 weeks). Functional results were excellent in 24 cases, good in 10 and poor in one. Most patients achieved functional range of motion at the knee joint (average flexion 1280) except one, who had a flexion of less than 1100. One patient with a delayed union united after bone marrow injection. Other complications included pin tract infections in 9 cases, axial malalignment of less than 100 in 4 cases and a prominent screw in one. Conclusion: Percutaneous restoration of articular anatomy and a ring external fixation with or without minimal internal fixation is an excellent method of treatment in this group of fractures caused by high energy trauma and with a usual association of severe comminution and a poor soft tissue envelope.