Vol. 8, Issue 2, Part A (2024)

This study focused on assessing the clinical, functional, and radiological results of Treating comminuted intra-articular fractures of the proximal tibia with dual fixation procedures, which involve an Ilizarov external fixator in combination with a postero-medial plate. Assessing the efficacy of this strategy in bettering patient outcomes was the primary outcomes via postero-medial approach and compare our results with other fixation methods and with other centers.

Methods: The study involved 20 patients diagnosed with Schatzker type V and VI plateau fractures of tibia, all of whom were pretened to the Orthopedics Department and Trauma at Shebin El-Kom Teaching Hospital. All patients underwent general and local examination, and radiological evaluation by Plain X-Ray, CT scanning and MRI.

Results: Union occurred in 18 (90%) casesThe duration of union for the fractures varied between 12 and 20 weeks, with an average time of 15.8±2.28 weeks. The ASAMI bone assessment revealed an excellent outcome in 11 (55%) patients, good outcome in 5 (25%) patients, fair outcome in 3 (15%) patients and poor outcome in 1 (5%) patient. The multivariate analysis of logistic regression indicated that hypertension, age, and diabetes mellitus did not significantly predict fracture union. These factors were found to be insignificant in their influence on the healing process.

Conclusion: The use of dual fixation with ilizarov external fixator and postero-medial plate via treatment option for difficult Schatzker type V and VI tibial plateau fractures is the postero-medial technique, which is both safe and successful.