ILIZAROV AND LOCKING PLATE FIXATION FOR CLOSED BICONDYLAR TIBIAL PLATEAU FRACTURESA PROSPECTIVE STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 64
Abstract
BACKGROUND In bicondylar tibial plateau fractures, the most frequently used treatment is ORIF with screws and plates; however, the soft tissue complications are frequently reported. Minimally-invasive Ilizarov technique is an alternative. The purpose of this study was to compare and analyse the clinical and radiological results of locking plate and Ilizarov technique in bicondylar tibial plateau fractures treated at a level I trauma centre. MATERIALS AND METHODS The patients with closed isolated bicondylar tibial fractures (Schatzker V/VI) were included in the study. Fifteen patients (8 of type V and 7 of type VI) in one group were treated using locked plating system and fifteen patients (5 of type V and 10 of type VI) in another group were treated with Ilizarov technique. Pre- and post-operatively, conventional radiographs, CT scans, hospital stay and complications were evaluated. The outcomes were evaluated using modified Rasmussen clinical and radiological criteria. RESULTS The two groups were similar demographically. Both the techniques achieved acceptable osseous reduction. When compared with internal fixation, Ilizarov had increased average range of motion (124˚ vs 117˚), decreased complications (p= 0.01), reduced hospital stay (0.001), earlier weight-bearing and marginally faster recovery (outcome in terms of modified Rasmussen clinical assessment score) at 6 months. But the outcomes were not significantly different at 1 year. In this study, Ilizarov technique had slight favourable outcome compared to locked plating group. CONCLUSION The Ilizarov method produces a good clinical outcome and is a valuable alternative treatment for bicondylar tibial plateau fractures with added advantage of decreased hospital stay, decreased waiting time for definitive surgery and early weight bearing.
Authors and Affiliations
Kartheek R, Kotilingam Kodandapani
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