Abstract

Background: Comminuted tibial plateau fractures (CTPF) almost associated with intraarticular extension and various degree of soft tissue injury. Ilizarov fixator provides a rigid fixation for these fractures and allows immediate mobilization of the joints and early weight bearing.

Purpose: evaluation of results of the Ilizarov ring fixator method in patients with CTPF regard to union, complication rates and final functional outcome.

ethods: A prospective cohort study was carried out for patients with CTPF in Aswan University Hospital and Assiut University Hospital utilizing ilizarov ring external fixator.

Material: Twenty consecutive patients with CTPF were classified according Schatzker’s classification; 9 patients were type VI, 7 patients were type V and 4 patients were type IV, 17 open and 3 closed fractures. The mean age was 34.05 (ranged from 20-54) years, 16 male and 4 females.

Results: All fractures united at a mean time 21 (ranged from 14 to 25) weeks. The ilizarov fixators were removed after mean of 16.5 (range from 13 to 29) weeks. The average follow up was 19 (range 15-24) months. The outcome was excellent in 12, good in 6 and fair in 2 according the rating system of Hospital for Special Surgery (HSS knee score). Five cases recorded malunion. The final knee range of motion ranged from 0ᵒ to 160ᵒ with mean 105ᵒ with cases of schatzker, type V and VI, while type IV fractures had 125ᵒ mean knee range. One case suffered from total stiff knee in 0ᵒ extension. Three cases with ligamentus laxity but without functional disability.There was a direct correlation (P<0.005) between the type of the fracture and number of ilizarov rings in relation to the final outcome.

Conclusion: Ilizarov fixator allows early definitive treatment with early weight-bearing in CTPF with low complication rate in either extra-articular or intra-articular fractures.

Keywords: Ilizarov; External fixator; Metaphyseal; Tibial; Fractures