Plating versus Ilizarov Technique for Complex Tibial Plateau Fractures: A Comparative Study on Functional Outcome and Patient Satisfaction

Abstract

Objective To compare clinical and functional outcomes and complications of open reduction internal fixation (ORIF) by plating and Ilizarov technique in complex tibial plateau fractures. Methods This study is a randomized clinical trial accompanying 56 patients having Schatzker type V and VI tibial plateau fractures. We divided patients into two groups for management. Group I; open reduction internal fixation and Group II; ilizarov technique. We conducted study at the orthopedics department, Jinnah Post-Graduate Medical Center, Karachi, from April-2018 to Oct-2020. The endpoint was to assess patients’ satisfaction and clinical and functional outcomes up to an 18-month follow-up. Results The etiology of tibial fracture was mainly road traffic accident (RTA); 17 (70.9%) in ORIF versus 23 (71.8%) in the Ilizarov group. According to clinical outcomes, excellent extension lag was achieved in 100% of patients in both groups. Most patients had excellent knee flexion, thigh atrophy and instability outcomes (54.1% vs 59.37%, 87.5% vs 81.2% and 83.3% vs. 87.5%). The functional outcome assessment was done and recorded for 18 months of follow-up. There was no significant difference in normal walking, stair climbing, squatting, jumping and duck walking between the groups. The overall rate of complications was similar; 11 (45.8%) in ORIF versus 17 (53.12%) in the illizarov group (p=0.78). Conclusion Our study concludes that there is an excellent clinical and functional outcome found in both procedures as both are safe and effective procedures with fewer complications Keywords Complex Tibial Plateau Fractures, ORIF, Ilizarov Technique