Results of management of tibial plateau fractures Schatzker types V and VI using Ilizarov fixator

Abstract

Background Management of comminuted bicondylar tibial plateau fractures remains a challenge to orthopedic surgeons. Studies on long-term outcomes of treatment of the tibial plateau have included a mixture of fracture types, including low-energy split and split-depressed fractures. Thus, the middle-to-long-term results of management of high-energy fractures are still lacking. Objective The aim of this study was to evaluate the knee function and development of arthrosis after a minimum of 3 years in high-energy tibial plateau fractures treated with the Ilizarov external fixator. Patients and methods There were 30 patients in this study and they were followed up for a minimum of 3 years. Completion of the Iowa knee score and the Short Form-36 General Health Survey was a must. This retrospective study was performed at an academically supervised level III, trauma center, in which percutaneous and/or limited open internal fixation and an Ilizarov frame were applied for displaced bicondylar high-energy tibial plateau fractures (Schatzker types V and VI, and Orthopedic Trauma Association types C1, C2, and C3). Results After healing, none of the studied patients needed a secondary reconstructive procedure. The knee motion ranged between 15° of extension and 155° of flexion, with an average of 88% of the total arc of the contralateral knee. Conclusion Patients suffering from high-energy bicondylar tibial plateau fractures could be safely treated with minimal internal fixation and Ilizarov external fixation. This procedure has good prognosis for satisfactory knee function for up to 16 years of follow-up.