Results of ring (Ilizarov) fixator in high energy Schatzker type VI fractures of proximal tibia

Debnath, Ujjwal K.; Jha, Dipak Kumar; Pujari, Prasanta Kumar

doi:10.1016/j.jcot.2017.08.005

Cited by 15 publications

(29 citation statements)

References 32 publications

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“…A recent study also allowed immediate weight bearing as tolerated specifically in Schatzker type 6 fractures. 40 In Keightley et al 19 the mean ROM achieved was 110 degrees with one patient having a fixed flexion deformity of >10 degrees.…”

Section: Discussionmentioning

confidence: 95%

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

Verma

Venkateshaiah

Gajapurada

2020

International Journal of Recent Surgical and Medical Sciences

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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.

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Section: Discussionmentioning

confidence: 95%

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

Verma

Venkateshaiah

Gajapurada

2020

International Journal of Recent Surgical and Medical Sciences

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“…Keightley et al reported good long-term healing and functional outcomes in Schatzker type IV-VI tibial plateau fractures treated with an Ilizarov technique [ 16 , 17 ]. Debnath et al recommended the Ilizarov technique for Schatkzer type VI tibial plateau fractures with comminution [ 18 ]. Reddy et al reported good healing rates and low incidence of infection in Schatzker type II and above tibial plateau fractures [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment of Schatzker Type II-VI Tibial Plateau Fractures by Means of Syndesmotaxis Using an Ilizarov External Fixator and Postoperative CT Evaluation

Papadakis¹,

Pallis²,

Ampadiotaki³

et al. 2021

Cureus

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Introduction Tibial plateau fractures are more common in young patients following high-energy trauma. In this study, we aim to evaluate the articular surface reduction quality by means of postoperative computer tomography (CT) in Schatzker type II-VI tibial plateau fractures treated with an Ilizarov frame. Materials and methods This case series study included 45 patients with a mean age of 39.5 years (range: 18 to 65 years) with a Schatzker type II-VI tibial plateau fracture. The surgical technique was a mini-open reduction of the articular surface impaction followed by application of an Ilizarov circular frame with knee bridging. Pre- and postoperative CT scan evaluation was performed in all of the patients. Outcomes were measured using the American Knee Society Score (AKSS). Mean outpatient follow-up was of at least 12 months (range: 12 to 21 months). Mean time for fracture consolidation was 15.5 weeks (range: 13 to 19 weeks). According to the degree of postoperative articular surface impaction, patients were grouped as follows: 11 had less than 2 mm of depression, 27 had 2 to 4 mm of depression, and 7 over 4 mm of depression. Results Patients with articular surface impaction of more than 4 mm presented statistically significant lower values of AKSS compared to those with impaction of lower than 2 mm (p<0.001 ) and 2-4 mm (p<0.001). Patients with joint alignment equal to or more than 5 ° presented statistically significant lower values of AKSS compared to those with lower than 5 ° . Conclusions Schatzker type II-VI tibial plateau fractures may be treated successfully with mini-open reduction and the application of an Ilizarov frame. The increase of articular surface impaction by 1 mm causes reduction of AKSS by 15 units. Patients with joint alignment equal to or more than 5 ° present lower values of AKSS. The preoperative CT scan is important and useful in planning the surgical intervention no matter the classification system is used.

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“…Debnath et al [ 21 ], Gill and Raza [ 22 ], Zhao et al [ 23 ], and Nesari et al [ 24 ] believe that the Ilizarov technique is better for the management of complex tibial plateau fractures, which have extensive comminution with compromise of soft tissue and should be preferred over other methods. Whereas Tahir et al [ 25 ], Pineda et al [ 26 ], Metcalfe et al [ 27 ], and Boutefnouchet et al [ 28 ] believe that mode of fixation (ORIF or Ilizarov ring fixator) do not make any difference in the outcome.…”

Section: Discussionmentioning

confidence: 99%

Ilizarov Fixation Method of Tibia Plateau Fractures: A Prospective Observational Study

Baloch

Rafi

Junaid

et al. 2020

Cureus

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Background: Tibia plateau fractures are most commonly managed with open reduction and internal fixation (ORIF) technique, external fixation via minimally invasive technique are an excellent alternative. The aim of this study was to assess the results of tibia plateau fractures by using the Ilizarov external fixator. The analysis was done both clinically and radiologically. Methodology: Some 72 patients with isolated tibia plateau fractures were brought to ED and clinics and assessed. The fractures were classified according to Schatzker Tibia Plateau Fracture classification, only Schatzker type III to VI were included using conventional X-rays. All patients for their tibia plateau fractures underwent surgical correction using Ilizarov technique with full weight bearing and knee range of motion allowed the next day. Patient follow-up up to one year was done. KOOS and self-appraisal were used to evaluate the knee pain and function. Results: All the fractures healed with 67 patients achieving a range of motion better than 0-100º. KOOS score shows that patients who had worse fracture patterns (Schatzker-V and VI) have worse global scores (p=0.002); still when managed with an Ilizarov it has been seen that these patients are able to maintain a moderately pain free knee (p=0.013) other aspects of the KOOS. Patients with higher BMI showed to have worsening fracture patterns with 20 out of the 30 overweight patients suffering Schatzker-V (66.67%). We experienced an extremely low rate of pin tract infections with only two debridements required. Conclusion: Ilizarov external fixation method is a valuable alternative treatment with excellent clinical outcomes and early mobilization.

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Results of ring (Ilizarov) fixator in high energy Schatzker type VI fractures of proximal tibia

Abstract: The technique is well suited for the management of complex fractures of the proximal tibia (Schatzker VI) when extensive comminution at the fracture site and compromise of the soft tissue is present.

Cited by 15 publications

References 32 publications

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

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

Treatment of Schatzker Type II-VI Tibial Plateau Fractures by Means of Syndesmotaxis Using an Ilizarov External Fixator and Postoperative CT Evaluation

Ilizarov Fixation Method of Tibia Plateau Fractures: A Prospective Observational Study

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