Outcomes in Schatzker Type 5 and Type 6 Tibial Plateau Fractures Treated with Ilizarov External Fixator: Follow-up in 30 Patients

Abstract

Introduction Fractures of the proximal tibia, particularly those that extend into the knee joint, are serious injuries that frequently result in functional impairment. Complications include infection, compartment syndrome, stiffness, skin loss, and possible amputation. These can be minimized using the Ilizarov external fixator which allows early weight bearing, minimal soft tissue injury, and a multiaxial stable fixation. Materials and Methods A total of 30 patients with open/closed Schatzker type 5 and 6 tibial plateau fractures were studied for outcome following surgery and implant removal using the modified Hohl and Luck criteria which include functional (extensor lag, valgus or varus instability, knee range of movement, walking distance and pain) and radiological parameters (valgus/varus deformity, depression of articular surface, and osteoarthritis). Results In our study, out of 30 patients 53.3% patients had an excellent outcome functionally, whereas 23.3% had a good outcome, 13.3% fair, and 10% had a poor outcome. Radiologically, 46.6% had an excellent outcome, 40% had a good outcome, and 13.3% had a fair outcome. All the patients achieved union with a mean time of 23.9 weeks. Common complication was pin tract infection in 13.3% patients. In total, 60% of the patients could be mobilized immediately with the remaining mobilized within 1 to 4 weeks. Conclusion Most patients had an excellent to good functional or radiological outcome once the implant was removed. Weight bearing could be started immediately in most cases with minimal complications encountered in few patients like pin tract infection, deep venous thrombosis, and osteomyelitis.