Ilizarov external fixation versus open reduction and internal fixation for complex tibial plateau fractures: a prospective randomised comparative study.

PURPOSE: To compare the clinical and functional outcomes of Ilizarov external fixation versus open reduction and internal fixation in the management of complex tibial plateau fractures.

METHODS

A prospective, randomised comparative clinical study was conducted at two trauma centres including 40 adult patients with Schatzker types IV-VI tibial plateau fractures. Patients were randomly assigned to internal fixation (n = 20) or Ilizarov external fixation (n = 20).

RESULTS

Patients in the external fixation group (Group B) started partial weight-bearing significantly earlier (mean 6.6 weeks) compared to the internal fixation group (Group A; mean 9.6 weeks; p = 0.002). Full weight-bearing was also achieved significantly sooner in Group B (mean 11 weeks) compared to Group A (mean 17.65 weeks; p < 0.001). Healing time, Knee Society Scores, pain, and range of motion were comparable.

CONCLUSION

Ilizarov external fixation facilitates earlier partial and full weight-bearing compared to internal fixation, with similar healing times and functional outcomes, suggesting its efficacy as an alternative to internal fixation for complex tibial plateau fractures.