Vol. 5, Issue 1 (2019)
Evaluation of complex tibial plateau fractures treated with Ilizarov circular fixator
Author(s): Mehtab Ahmed Pirwani, Jagdesh Kumar, Muhammad Soughat Katto, Nusrat Rasheed, Irfan Muhammad Rajput, Muhammad Jamil
Abstract: Introduction: Ilizarov circular fixator is now considered as a suitable alternate treatment modality for stabilization of complex tibial plateau fractures. This method of treatment minimizes iatrogenic soft tissue dissection and it’s associated complications because of closed percutaneous wire fixation and permits early knee mobilization and weight bearing due to its three-dimensional stability. Objective: This study was undertaken to evaluate the clinico- radiological outcomes and morbidity of the Ilizarov circular fixator applied for stabilization of complex tibial plateau fractures. Study Design: Prospective analytic cross-sectional design Place and Duration of study: Orthopaedic department of Dow Medical College / Dr. Ruth Pfau Civil Hospital Karachi, between November 2015 to September 2018. Methodology: A total of 21 consecutive patients with complex tibial plateau fracture (Schatzker type V & VI) operated with Ilizarov circular fixator technique, were evaluated clinico-radiologically by using the scoring criteria of ASAMI. Post-surgical complications were noted. Polytrauma patients with multiple fractures, age < 18 years, delayed presentation (> 2 weeks) and fracture with associated vascular injury were excluded from the study. Results: The minimum follow-up was 3 months after complete frame removal. All fractures were united in average 14.6 weeks (range 12-32 weeks). According to ASAMI scoring system, the final results were excellent to good in 80.8%, and fair in 19%. There was 66.6% pin tract infection in this series. Knee joint osteoarthritis was noted in five patients. We had no instance of postoperative deep infection and neurovascular complications due to Ilizarov fixation. Conclusions: Primary Ilizarov circular fixator combined with limited internal fixation is a valuable treatment alternate for complex tibial plateau fractures that are not immediately amenable to internal fixation.