Baloch Shahzaib R, Rafi Mohammad S, Junaid Javeria, Shah Mohammad, Siddiq Faateh, Ata-Ur-Rahman Syed, Zohaib Zardana
Orthopaedics, Dr. Ziauddin University Hospital, Karachi, PAK.
Biochemistry, Mekran Medical College, Turbat, PAK.
Cureus. 2020 Oct 31;12(10):e11277. doi: 10.7759/cureus.11277.
Tibia plateau fractures are most commonly managed with open reduction and internal fixation (ORIF) technique, external fixation via minimally invasive technique are an excellent alternative. The aim of this study was to assess the results of tibia plateau fractures by using the Ilizarov external fixator. The analysis was done both clinically and radiologically.
Some 72 patients with isolated tibia plateau fractures were brought to ED and clinics and assessed. The fractures were classified according to Schatzker Tibia Plateau Fracture classification, only Schatzker type III to VI were included using conventional X-rays. All patients for their tibia plateau fractures underwent surgical correction using Ilizarov technique with full weight bearing and knee range of motion allowed the next day. Patient follow-up up to one year was done. KOOS and self-appraisal were used to evaluate the knee pain and function.
All the fractures healed with 67 patients achieving a range of motion better than 0-100º. KOOS score shows that patients who had worse fracture patterns (Schatzker-V and VI) have worse global scores (p=0.002); still when managed with an Ilizarov it has been seen that these patients are able to maintain a moderately pain free knee (p=0.013) other aspects of the KOOS. Patients with higher BMI showed to have worsening fracture patterns with 20 out of the 30 overweight patients suffering Schatzker-V (66.67%). We experienced an extremely low rate of pin tract infections with only two debridements required.
Ilizarov external fixation method is a valuable alternative treatment with excellent clinical outcomes and early mobilization.
胫骨平台骨折最常用切开复位内固定（ORIF）技术治疗，通过微创技术进行外固定是一种很好的替代方法。本研究的目的是评估使用伊里扎洛夫外固定器治疗胫骨平台骨折的结果。从临床和放射学两方面进行分析。
约72例单纯胫骨平台骨折患者被送至急诊科和门诊进行评估。根据沙茨克胫骨平台骨折分类法对骨折进行分类，仅使用传统X线纳入沙茨克III型至VI型骨折。所有胫骨平台骨折患者均采用伊里扎洛夫技术进行手术矫正，术后次日允许完全负重和膝关节活动。对患者进行了长达一年的随访。使用膝关节损伤和骨关节炎疗效评分（KOOS）和自我评估来评估膝关节疼痛和功能。
所有骨折均愈合，67例患者的膝关节活动范围超过0-100°。KOOS评分显示，骨折类型较差（沙茨克V型和VI型）的患者总体评分较差（p=0.002）；然而，使用伊里扎洛夫外固定器治疗时发现，这些患者在KOOS的其他方面仍能够保持膝关节中度无痛（p=0.013）。体重指数较高的患者骨折类型更差，30例超重患者中有20例为沙茨克V型骨折（66.67%）。我们的针道感染率极低，仅需进行两次清创。
伊里扎洛夫外固定方法是一种有价值的替代治疗方法，具有良好的临床效果和早期活动能力。
