Analysis of functional outcome of complex tibial plateau fractures (Schatzker Type 5 and Type 6) treated with hybrid external fixators

Abstract

Introduction: Tibial fractures type V and VI are complex injuries usually treated with ORIF (Open Reduction and Internal Fixation) which have increased risk of wound complications. The hybrid external fixer helps to mitigate these complications by permitting early mobilization and bearing of weight, minimal soft tissue damage, and stable fixation. Aim: To analyzethe functional outcome of hybrid external fixator-treated tibial plateau fractures (Schatzker type 5 and 6). Methods: The study included 30 patients who hadtibial platform fractures of Schatzker Type V and type VI. Patients offered informed consent and a 2 years follow-up following surgery was done. We have applied K’wire or minimal open reduction with cancellous screw and universal external fixator. The analyses were performed with Neer's Rating System for Knee. Results: Out of 30 patients, 26 patients were males, and 4 patients were females. Mean age was 42.34 years. Based on outcomes, 40% of the study population had an excellent and good effect, 17% had fair outcome, 3% had a poor outcome. Based on the type of fracture, 12 patients had Schatzker type V, 18 patients had Schatzker type VI, 10 patients had closed fracture, 20 patients had a compound fracture. Based on mode of injury, 85% had a road traffic accident, 10% had assaulted, 5% had fall injury. Based on complication, 23% had pin tract infection, 17% had knee stiffness, 3% had malunion, 3% had shortening, and 10% had wound infection. Conclusion: In this report, we have concluded that a promising alternative therapy for high-energy plateau fractures is a hybrid external fixator. Without high complication rates, it permits a safe fixation of fraction fragments, early joint recovery and the treatment of related soft tissue injuries.