Skip to main content


Log in

Complex tibial plateau fractures treated with Ilizarov external fixator with or without minimal internal fixation

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript


We treated 30 tibial plateau fractures (Schatzker Type VI) in 29 patients, with a mean age of 41.4 (20–76) years, with the Ilizarov fixator. In 18 fractures, we combined the treatment with minimal internal fixation. All fractures were the result of high-energy trauma, and 20 patients had associated injuries. Twenty-eight fractures were available for follow-up after 27 (16–36) months. Using The Knee Society clinical rating system, 18 knees were rated as excellent, seven as good, one as fair, and two as poor. There was a direct correlation between the presence of associated injuries and the final outcome. The most significant concomitant injuries were distal femoral fractures and extensive soft-tissue injury. This study emphasizes the clinical success and low morbidity associated with the use of external fixation and minimal internal fixation.


Nous avons traité chirurgicalement 30 fractures du plateau tibial (Type Schatzker VI) chez 29 malades—âge moyen de 41,4 ans (20–76)—avec un fixateur d’Ilizarov. Pour 18 fractures nous avons combiné le traitement avec une fixation interne légère. Toutes les fractures étaient le résultat d’un traumatisme à haute énergie et 20 patients avaient des lésions associées. Après un suivi de 27 mois (16–36) 28 fractures étaient étudiables. Avec le score de la Knee Society, 18 genoux ont été estimés comme excellents, sept comme bons, un comme moyen, et deux comme mauvais. Il y avait une corrélation directe entre la présence de blessures associées et le dernier résultat, le plus significatif étant l’existence d’une fracture fémorale distale et l’importance des lésions des parties molles. L’étude met en relief le succès clinique et la basse morbidité associés à l’usage du fixateur externe et de la fixation interne légère.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others


  1. Ballmer FT, Hertel R, Notzli HP (2000) Treatment of tibial plateau fractures with small fragment internal fixation: a preliminary report. J Orthop Trauma 14:467–474

    Google Scholar 

  2. Buckle R, Blake R, Watson JT et al (1993) Treatment of complex tibial plateau fractures with the Ilizarov external fixator. J Orthop Trauma 7:167

    Google Scholar 

  3. Collinge C, Sanders R, DiPasquale T (2000) Treatment of complex tibial periarticular fractures using percutaneous techniques. Clin Ortop 375:69–77

    Google Scholar 

  4. Dendrinos GK, Kontos S, Katsenis D, Dalas A (1996) Treatment of high-energy tibial plateau fractures by the Ilizarov circular fixator. J Bone Joint Surg Br 78:710–717

    Google Scholar 

  5. Guadinez RF, Mallik AR, Sporn M (1996) Hybrid external fixation of comminuted tibial plateau fractures. Clin Ortop 328:203–210

    Google Scholar 

  6. Gustilo RB, Anderson JT (1976) Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones. J Bone Joint Surg Am58:453–461

    CAS  PubMed  Google Scholar 

  7. Gustilo RB, Mendoza RM, Williams DN (1984) Problems in the management of type III (severe) open fractures: a new classification of type III open fractures. J Trauma 24:742–746

    CAS  PubMed  Google Scholar 

  8. Hefny HM (2000) Treatment of complex tibial plafond injuries using Ilizarov methodology. Pan Arab J Orthop Trauma 4:37–42

    Google Scholar 

  9. Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Ortop 248:13–14

    Google Scholar 

  10. Jensen DB, Rude C, Duus B, Bjerg-Nielsen A (1990) Tibial plateau fractures. A comparison of conservative and surgical treatment. J Bone Joint Surg Br 72:49–52

    CAS  PubMed  Google Scholar 

  11. Koval KJ, Helfet DL (1995) Tibial plateau fractures evaluation and treatment. J Am Acad Orthop Surg 3:86–94

    Google Scholar 

  12. Kumar A, Whittle AP (2000) Treatment of complex (Schatzker type VI) fractures of the tibial plateau with circular wire external fixation: retrospective case review. J Orthop Trauma 14:339–344

    Google Scholar 

  13. Lobenhoffer P, Tscherne H, Schulz M et al (1999) Closed reduction/percutaneous fixation of tibial plateau fractures. J Orthop Trauma 13:426–431

    Google Scholar 

  14. Mallik AR, Covall DJ, Whitelaw GP (1992) Internal versus external fixation of bicondylar tibial plateau fractures. Orthop Rev 21:1433–1436

    Google Scholar 

  15. Marsh JL, Smith ST, Do TT (1995) External fixation and limited internal fixation for complex fractures of the tibial plateau. J Bone Joint Surg Am 77:661–673

    CAS  PubMed  Google Scholar 

  16. Mikulak S, Gold S, Zinar D (1998) Small wire external fixation of high-energy tibial plateau fractures. Clin Ortop 356:230–238

    Google Scholar 

  17. Morandi M, Pearse MF (1996) Management of complex tibial plateau fractures with the Ilizarov external fixator. Tech Orthop 11:125

    Google Scholar 

  18. Rasmussen PS (1973) Tibial condylar fractures: impairment of knee joint stability as an indication for surgical treatment. J Bone Joint Surg Am 55:1331–1350

    CAS  PubMed  Google Scholar 

  19. Schatzker J, McBroom R Bruce D (1979) The tibial plateau fracture. The Toronto experience 1968–1975. Clin Ortop 138:94

    Google Scholar 

  20. Tscherne H, Gotzen L (eds) (1984) Fractures with soft tissue injuries. Springer, Berlin Heidelberg New York

    Google Scholar 

  21. Watson JT, Coufal C (1998) Treatment of complex lateral plateau fractures using Ilizarov techniques. Clin Ortop 353:97–106

    Google Scholar 

  22. Weiner LS, Kelley M, Yang E et al (1995) The use of combination internal fixation and hybrid external fixation in severe proximal tibia fractures. J Orthop Trauma 9:244–250

    CAS  PubMed  Google Scholar 

  23. Young MJ, Barrack RL (1994) Complications of internal fixation of tibial plateau fractures. Orthop Rev 23:149–154

    Google Scholar 

  24. Zecher SB, Danziger MB, Segal D, Foster T, Whitelaw GP, Covall DJ (1996) Treatment of high-energy proximal tibial fractures using the Monticelli–Spinelli external fixator: a preliminary report. Am J Orthop 25:49–54

    Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to H. Abdel Ghani.

Rights and permissions

Reprints and permissions

About this article

Cite this article

El Barbary, H., Abdel Ghani, H., Misbah, H. et al. Complex tibial plateau fractures treated with Ilizarov external fixator with or without minimal internal fixation. International Orthopaedics (SICOT) 29, 182–185 (2005).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: