Ilizarov ring fixator for management of Schatzker type v and vi fractures of proximal tibia: A study of 30 cases

Abstract

Introduction: Bicondylar tibia fractures are mostly treated by ORIF in a staged manner and involve lot of periosteal stripping and soft tissue disruption with potential complications of infection, hardware failures, compartment syndrome and delayed ambulation. Trans-osseous osteosynthesis using Ilizarov ring fixator seems to be a better emerging option for treating such fractures with minimal complications and better clinical and functional outcome. The aim of this study is to evaluate the role of Ilizarov ring fixator in Schatzker type V and VI fractures of proximal tibia. Methods: 30 patients with these injuries were included in the study after careful inclusion and exclusion criteria. All underwent standard Ilizarov ring fixation method with trans- fixation of knee in type VI fractures, which was removed at around 3 - 4 weeks and knee mobilization was started. Early weight bearing was encouraged in all cases except two with humerus fracture. Clinical followup was done at monthly intervals along with radiological evaluation. Pin site care was repeatedly stressed for and taught. Final follow up was done at six months post frame removal and Karlstrom-Olerud scoring system was used to analyze the final outcome. Results: There was no incidence of superficial or deep infection. All the fractures healed in time. Incidence of pin tract infection was 26.6% but it resolved with proper dressings and antibiotics. Average union time was around 17.46 weeks. There was no incidence of deep vein thrombosis or compartment syndrome or peroneal nerve injury. Overall result was Excellent in 12 cases, Good in 11 cases, Fair in 4 cases and Poor in 3 cases. Conclusion: Ilizarov fixator is a good, reliable and easily reproducible method of treating such fractures with early return to pre-injury levels in most of the cases.