Publication:

Schatzker V-VI fractures of tibial plateau healed fast within 3.5 months: Ilizarov fixation with 6 weeks femoral ring offload

Background Schatzker V and VI tibial plateau fractures with significant soft-tissue injury, the Ilizarov circular fixator provides essential, stable fixation while minimizing further disruption. A key advantage is the staged removal of the distal femoral ring, which allows for earlier knee mobilization and is critical for preserving long-term joint function. To evaluate the effectiveness of a three-and-a-half-month union strategy using Ilizarov fixation with distal femoral ring removal at six weeks in patients with Schatzker type V and VI tibial plateau fractures.

Methods This prospective cohort study was conducted at Department of Orthopedics, National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka, Bangladesh, Bangladesh, from January 2023 to December 2024. A 41-patient cohort undergoing Ilizarov fixation with femoral ring removal at six weeks was assessed for union, knee motion, alignment, weight-bearing, and complications. Data analysis was performed using SPSS version 23.0 to evaluate these outcomes.

Results The study cohort (mean age 38.6±9.4 years, 70.7% male) showed favorable outcomes. Radiological union was achieved in 87.8% of patients at a mean of 14.2±1.6 weeks, with 90.2% maintaining acceptable alignment. Final mean knee flexion was 118°±12°. Complications included pin-tract infection (14.6%) and stiffness (9.8%), with no deep infections or non-unions.

Conclusions Ilizarov fixation with planned distal femoral ring removal at six weeks is an effective strategy for managing Schatzker type V and VI tibial plateau fractures, promoting early union, functional recovery, and low complication rates.