Treatment of Tibial Plateau Fractures By Circular External Fixator

Abstract

Background: Tibial plateau fracture is challenging for orthopaedic surgeons because of the severity of trauma and associated soft tissue injuries. The treatment goals are to anatomically reconstruct the proximal tibial articular surface, restore limb axial alignment, and fix metadiaphyseal comminution to allow early knee mobilization and weight bearing.Aim: To evaluate the functional, clinical and radiological outcomes of treatment of high energy tibial plateau fractures by circular external fixator ± percutaneous screw fixation.Patients and Methods: Between June 2018 and July 2019, 20 tibial plateau fractures in 20 patients were treated with Ilizarov external fixator in Benha University hospital. The mean age was 39 years (range 22–55 years), and the mean follow-up period was 11±2 months (range 8–12 months). Closed reduction was performed by closed means in 70% of cases or through minimal incisions in 30% of cases. Clinical and functional evaluation of patients in the tibial plateau group was performed.Results: All patients started weight bearing the day after the surgery. Functionally, 70% had an excellent result, 20% had a good result. Radiologically 75% of had excellent results. Pin tract infection was controlled in all patients without need to implant removal.Conclusion: The degree of soft tissue injury associated with tibial plateau fracture is an important determinant for both the choice of the treatment modality and the prediction of treatment outcome. The use of Ilizarov external fixator is safe and effective option for the treatment of difficult Schatzker IV, V and VI tibial plateau fractures.