Background: Tibial plateau fractures resulting from high energy trauma, typically Schatzker type IV, V and VI pattern fractures are difcult to deal
with due to poor overlying soft tissue cover. Ligamentotaxis with ilizarov ring xator can be a suitable denitive treatment option for such injuries
with fewer associated complications as compared to internal xation.
Patients and Methods: 30 patients within the age group of 18-80 years with Schatzker type IV, V and VI pattern injuries were included in the study.
A four ring ilizarov assembly was used with knee spanning with a proximal femoral ring. The patients were followed for 12 months and evaluation
was analyzed as per Rasmussen clinical and radiological criteria.
Results: The mean age of patients in our study was 39.76 years. Twenty cases were Schatzker type VI, 7 cases were Schatzker type IV (with
extensive soft tissue swelling following high velocity trauma) and only 3 cases were type V. The mean duration of surgery was 47±12 mins without
bone grafting and 72±14 mins with bone grafting. The mean interval from injury to surgery was 2.36 days (range 1-5 days). Rasmussen total
anatomical outcome was excellent in 14 patients(46.66%) and good in 16 patients(53.33%). Rasmussen total functional outcome was excellent in
21 patients(70%) and good in 9 patients(30%). Final Outcome was excellent in 22 patients(73.33%) and good in 8 patient(26.66%).
Discussion: High velocity tibial plateau fractures, when treated with internal xation and plating, carry a higher risk of associated complications
ranging from deep infections to even compartment syndrome. The rate of re-operation following internal xation in such injuries has been high
with most of the re-surgeries being required within one year of primary xation which adds to the morbidity of the patient. Ligamentotaxis with
ilizarov ring xation as denitive treatment in such cases can be a fruitful operation with lesser complications and early return to previous level of
activity.
Management of Soft Tissue Injuries Associated with Tibial Plateau Fractures
