Role of primary Ilizarov ring fixation for Schatzker Type V and VI bicondylar tibia fracture in tertiary care centre.

BACKGROUND

Proximal tibial fractures of Schatzker Type V and VI are complex, high-energy injuries with significant soft tissue compromise and articular depression. Conventional methods like ORIF often carry high complication rates. The Ilizarov ring fixator, being minimally invasive and biomechanically stable, offers a valuable alternative. This study evaluates the role of primary Ilizarov fixation in these fractures, focusing on functional and radiological outcomes, along with complications during follow-up.

METHODS

This prospective study included 30 patients (18-70 years) with Schatzker Type V and VI fractures treated with primary Ilizarov fixation at a tertiary center in Indore. Exclusion criteria were floating knee, pathological fractures, Schatzker Type I-IV, and other limb injuries. Preoperative evaluation used X-rays and 3D CT. Reduction was done via closed or minimally invasive methods, followed by Ilizarov application. Patients were followed at 2 weeks, 1, 3, and 6 months. Outcomes included KOOS, ROM, radiological union, and complication rates.

RESULTS

At 6 months, 56.67 % had excellent KOOS outcomes, 26.67 % good, and 16.67 % fair. Radiological union occurred within 4 months in 66.67 %, and by 6 months in 30 %. One non-union was managed with corticotomy. Complications were minimal, with 23.33 % pin tract infections and 6.67 % malalignment. Early mobilization improved ROM and recovery.

CONCLUSION

Primary Ilizarov fixation is a safe, effective option for managing Schatzker Type V and VI tibial plateau fractures. It permits early weight-bearing, preserves soft tissue, and yields excellent functional and radiological outcomes with minimal complications, making it a preferred choice in complex fractures with compromised soft tissue.