ILIZAROV-BASED RECONSTRUCTION FOR COMPLEX TIBIAL PLATEAU FRACTURES (SCHATZKER V-VI): A STUDY OF FUNCTIONAL AND RADIOLOGIC OUTCOMES.

Abstract

 Background: Complex tibial plateau fractures (Schatzker V-VI) present a significant surgical challenge due to articular comminution, metaphyseal-diaphyseal dissociation, and soft tissue compromise. The Ilizarov circular fixator offers advantages of stable fixation, early weight-bearing,
and simultaneous management of bone loss. This study evaluates the functional and radiological
outcomes of Ilizarov-based reconstruction for these fractures at a tertiary care center.
Methods: A prospective interventional study was conducted at BSMMU from January 2015 to
December 2017. Fifty consecutive adult patients with closed Schatzker type V and VI tibial plateau
fractures were managed with Ilizarov fixation, often using limited internal fixation for articular
reduction. Outcomes were assessed using the Rasmussen's functional and radiological scoring
systems at final follow-up (minimum 12 months). Complications were recorded.
Results: The mean patient age was 42.3 ± 10.5 years, with 76% males. The mean time to full weightbearing was 12.1 ± 2.3 weeks. At final follow-up, the mean Rasmussen functional score was 26.2 ± 3.1, with 72% (n=36) achieving good-to-excellent results. Radiologically, 68% (n=34) had good-toexcellent anatomical restoration. The most common complications were pin-tract infections (28%), all resolving with oral antibiotics. No cases of deep infection or non-union were observed.
Conclusion: Ilizarov circular fixation is an effective and reliable method for managing complex tibial plateau fractures, providing high rates of union, good functional outcomes, and enabling early mobilization. Its utility is particularly pronounced in settings with high-energy trauma and compromised soft tissues.