Abstract
Background: Tibia plateau fractures are most commonly managed with open reduction and internal fixation (ORIF) technique, external fixation via minimally invasive technique are an excellent alternative. The aim of this study was to assess the results of tibia plateau fractures by using the Ilizarov external fixator. The analysis was done both clinically and radiologically.Methodology: Some 72 patients with isolated tibia plateau fractures were brought to ED and clinics and assessed. The fractures were classified according to Schatzker Tibia Plateau Fracture classification, only Schatzker type III to VI were included using conventional X-rays. All patients for their tibia plateau fractures underwent surgical correction using Ilizarov technique with full weight bearing and knee range of motion allowed the next day. Patient follow-up up to one year was done. KOOS and self-appraisal were used to evaluate the knee pain and function.Results: All the fractures healed with 67 patients achieving a range of motion better than 0-100º. KOOS score shows that patients who had worse fracture patterns (Schatzker-V and VI) have worse global scores (p=0.002); still when managed with an Ilizarov it has been seen that these patients are able to maintain a moderately pain free knee (p=0.013) other aspects of the KOOS. Patients with higher BMI showed to have worsening fracture patterns with 20 out of the 30 overweight patients suffering Schatzker-V (66.67%). We experienced an extremely low rate of pin tract infections with only two debridements required.Conclusion: Ilizarov external fixation method is a valuable alternative treatment with excellent clinical outcomes and early mobilization.
Highlights
Fractures of the tibia plateau are a relatively common occurrence when we speak about lower limb fractures, as they contribute to approximately 1% of all fractures [1,2,3]
The fractures were classified according to Schatzker Tibia Plateau Fracture classification, only Schatzker type III to VI were included using conventional X-rays
KOOS score shows that patients who had worse fracture patterns (Schatzker-V and VI) have worse global scores (p=0.002); still when managed with an Ilizarov it has been seen that these patients are able to maintain a moderately pain free knee (p=0.013) other aspects of the KOOS
Summary
Fractures of the tibia plateau are a relatively common occurrence when we speak about lower limb fractures, as they contribute to approximately 1% of all fractures [1,2,3]. The mechanism of the injury contributes to a high rate of complications [5] and it tends to cause severe soft tissue damage [4]. The nature of these fractures demands active intervention especially due to the nature of the fracture involving a joint. The recommended treatment for tibia plateau fractures, Schatzker Type I-IV, has been open reduction and internal fixation (ORIF) using plates and screws. Tibia plateau fractures are most commonly managed with open reduction and internal fixation (ORIF) technique, external fixation via minimally invasive technique are an excellent alternative.
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