Assessment of Functional Outcome from the Hybrid Illizarov Technique in Patients with Complicated Tibial Plateau Fractures

Abstract

Background: Complex tibial plateau fractures pose challenges in orthopedic trauma care due to their intricate nature, potential for functional impairment, and involvement of articular disruption, metaphyseal comminution, and soft tissue injuries. Restoring joint alignment and ligament stability is crucial for favorable outcomes. Surgical methods like the Illizarov technique and its adaptations have gained attention. Existing literature reports around 50% satisfactory results regardless of closed or operative approaches. Failures result in pain, limited motion, deformities, and knee instability. Ilizarov's circular fixator is valuable for high-energy fractures with compromised soft tissues, offering stability and indirect reduction. Aim of the Study: This study evaluates the hybrid Illizarov technique's outcomes in restoring structure and function for complex tibial plateau fractures. Methods: This was a retrospective study. The study was conducted at the department of Orthopedics in North Bengal Medical College and Hospital, Sirajgonj, Bangladesh.  One hundred and fifty-two patients were prospectively recruited with knee osteoarthritis over one year of the study period from January 2020 to December 2022. Results: The study used the hybrid Ilizarov technique to investigate 27 patients who underwent surgical treatment for complex tibial plateau fractures. Most patients (74.07%) were aged 20-40, with the rest (25.93%) aged 41-60. Males made up 81.48% of participants, while females were 18.52%. BMI distribution showed that 44.44% had normal BMI, 29.63% were overweight, and 11.11% were obese. More injuries occurred on the right side (59.26%). Complications affected 44.44% of patients, including pin tract infections (22.22%) and joint stiffness (7.41%). Clinical outcomes varied, with around 60% achieving good outcomes, 25.93% excellent, 7.41% fair, and a similar number of poor. Conclusion: The Hybrid Illizarov Technique demonstrates promise in addressing complicated tibial plateau fractures, showcasing favorable functional outcomes. This approach can potentially enhance patient recovery and warrants further exploration in orthopedic practice.