Abstract
Background: Bicondylar tibial plateau fractures are serious injuries with a high incidence of complications. The fracture treatment protocol has to take into consideration soft-tissue complications that might develop with severe articular comminution. This prospective study aims at highlighting the role of ligamentotaxis and spanning external fixation as an effective method in treatment of such injuries. Methods: Twenty-three patients were admitted with bicondylar tibial plateau fractures. Seventeen men and six women with severe intraarticular comminution were treated with ligamentotaxis and fixation with two spanning external fixators. Patients were followed for 2 yr. Functional outcome was assessed using the Knee Society Scoring System directly after removal of the fixators then at 1 and 2 yr. Results: The scores of the patients ranged from 94-72, with an average of 82.4. Seven of the patients had an excellent score (80-100), and five had a good score (70-79). Conclusions: Ligamentotaxis and spanning external fixation is a safe and successful method for treatment of severely comminuted bicondylar tibial plateau fractures. This technique allows achievement of an acceptable reduction with avoidance of skin and soft-tissue complications. Level of Evidence: Level IV therapeutic study.
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