Management of Complex Tibial Plateau Fracture using Ilizarov External Fixator versus Internal Fixation

Abstract

The tibial plateau represents the entire proximal end of the tibia and is composed of medial and lateral weight bearing articular surfaces. The 2 articular surfaces are asymmetric both in size and concavity as well as relative density and strength. (1) The medial tibial plateau is the larger of the two, is concave in both planes, is covered with hyaline cartilage and carries about 60% of the knee’s load and consequently has increased subchondral bone and a stronger, denser plateau when compared with the lateral.(90) The lateral plateau is smaller, weaker, convex in both sagittall and coronal planes, and is also covered in hyaline cartilage. Due to this relative weakness combined with the natural valgus carry angle of the lower extremity , fractures of the lateral tibial plateau are more common.(2) There is numerous classification systems used for classifying tibial plateau fracture and facilitate the treatment. Schatzker classification, the three column classification described by Luo et al. has been the recent addition to the previous classification systems, AO classification and Hohl and Moore. (9) complex tibial plateau fractures considered types 5 and 6 according to shatzker classification