Outcomes of arthroscopic-assisted fixation of intra-articular proximal tibial fractures by circular external fixator

Abstract

Abstract Background Fractures of the tibial plateau usually result from high-energy trauma. Motor vehicle accidents seem to be the predominant cause worldwide. The objective of treating displaced fractures is to restore the articular surface anatomy and repair soft tissue injuries. We aim to improve the functional and radiological results of the arthroscopically assisted fixation of the tibial plateau fractures using Ilizarov fixator. Methods The study was carried out on patients attending to Orthopedic Surgery Department at a major metropolitan hospital in Egypt, between March 2019 to September 2020. Forty-five patients with tibial plateau fractures of Schatzker classification type II to type VI were operated on. Results The results indicate that the Ilizarov method is a valuable alternative in treating Schatzker II-VI fracture types. The mean time from injury to partial weight bearing (PWB) and full weight bearing (FWB) were 12.75 and 22.73 weeks, respectively. The mean Knee Society Score was 75.42 ± 9.91. Over 70% of self-reported Overall Functional Grades were deemed ‘good’ (n=21, 47.6%) or ‘excellent’ (n=12, 26.7%) at the end of the follow-up period. Pin tract infection was reported in 31(68.9%) cases, and delayed union developed in 7 (15.6%) cases. Conclusion Early and definite fixation is achieved with the Ilizarov and arthroscopic technique, allowing intra-articular assessment of the reduction, and management of associated intra-articular soft tissue injuries with immediate PWB. It is believed that this minimally invasive method does not lead to the additional morbidity and the combined advantages of arthroscopy and Ilizarov allows successful fixation and early activity.