EC Orthopaedics

Background: Using Ilizarov in management of comminuted Tibial plateau fractures is not a new method but it is increasing nowadays.

Purpose: Evaluate the outcomes of using Ilizarov external fixator in management of high energy tibial plateau fractures type V and VI according to Schatzker's classification.

Study Design: Prospective study.

Methods: We selected patients with type V and VI Schatzker's classification, explained to them the open reduction and internal fixation (ORIF) and Ilizarov external fixator (IEF) as a management techniques. Patients between 19 and 57 years old had been selected and managed with IEF as their choice. All cases were evaluated clinically and radiologically. The femoral frame was removed after a mean of 5 (range 4 - 7) weeks and the tibial frame was removed after healing of the tibia.

Results: They were 33 patients diagnosed as tibial plateau fractures, twenty eight males and 5 females with a mean age of 39.5 (19 - 57) years old. Twenty-five patients had Left (Lt) tibia fractures while 8 patients had Right (Rt) tibia fractures. Twenty nine patients had closed fractures and 4 had open fractures. Twenty cases were type V and 13 cases were type VI and all fractures united at a mean of 19.6 (range 16 - 36) weeks. All patients were followed up for 2 years for pain, stability, range of motion, limping, patient satisfaction, radiographs, and ability to return to pre injury activity level. All patients returned to work except one case. According to Lysholm score; 2 cases were excellent, 2 cases were poor and the remaining were good results. Complications occurred in the form of skin infection, skin loss, compartment syndrome and unhappiness with the device.

Conclusion: We recommend using Ilizarov external fixation for stabilization of closed or open high energy tibial plateau fractures type V and VI Schatzker's classification.

Keywords: High Energy Tibial Plateau; Ilizarov External Fixator

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