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

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Abstract

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.

Résumé

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.

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Correspondence to H. Abdel Ghani.

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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). https://doi.org/10.1007/s00264-005-0638-6

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