Management of Complex Tibial Plateau Fractures Usingthe Ilizarov External Fixator

Abstract

Background: High-energy bicondylar tibial plateau fractures are challenging because of articular comminution, metaphyseal bone loss, and associated soft-tissue compromise. Circular external fixation using the Ilizarov technique provides stable fixation with minimal soft-tissue disruption. Methods: A prospective study was conducted on twenty patients with Schatzker type V and VI tibial plateau fractures treated using the Ilizarov external fixator. Closed or minimally invasive reduction was achieved using ligamentotaxis, followed by frame application. Early knee range-of-motion exercises were initiated, and progressive weight bearing was allowed. Functional outcomes were evaluated using Rasmussen’s functional scoring system. Results: Fracture union was achieved in all patients (100%). The mean time to union was 18 weeks (range, 16–20 weeks). According to Rasmussen’s criteria, 80% of patients achieved good to excellent functional outcomes. Superficial pin-tract infection was the most common complication; no deep infection, malalignment, implant failure, or nonunion was observed. Conclusions: Ilizarov external fixation is a reliable and effective treatment option for complex tibial plateau fractures, particularly in high-energy injuries with compromised soft tissues.

Bangladesh Society of Anaesthesiologists.2023;36(2): 31-33