This comparative clinical study will evaluate and compare the functional outcomes of patients with Schatzker type V and VI tibial plateau fractures treated using either the locking plate technique or the hybrid Ilizarov technique. Functional outcome will primarily be assessed using the Rasmussen Knee Functional Score. Fracture healing, time to union, non-union, delayed union, and infection will also be assessed and compared between the two treatment groups.
Patients of either sex.
Age between 25 and 50 years.
Patients presenting within 2 weeks of sustaining the fracture.
Patients diagnosed with complex tibial plateau fractures classified as Schatzker type V or VI.
Associated ipsilateral limb fractures.
Pathological fracture of the tibia.
Associated major organ injuries.
Psychiatric illness that may interfere with participation or outcome assessment.
Parallel
Hybrid Ilizarov Fixation
Procedure/SurgeryPatients with Schatzker type V or VI tibial plateau fractures will undergo fracture reduction and fixation using a hybrid Ilizarov external fixation system under C-arm fluoroscopic guidance. Closed or minimally open reduction will be performed as appropriate. The construct will consist of a hybrid Ilizarov C-ring with appropriately tensioned Kirschner wires and Schanz screws. Additional wires or fixation components may be used when required to achieve adequate fracture stability and alignment. Bone graft or bone substitute may be used when clinically indicated.
Locking Plate Fixation
Procedure/SurgeryPatients with Schatzker type V or VI tibial plateau fractures will undergo fracture reduction and internal fixation using a locking compression plate under C-arm fluoroscopic guidance. The appropriate surgical approach and medial and/or lateral plate configuration will be selected according to fracture morphology, comminution, and stability. Bone graft or bone substitute may be used when clinically indicated. Postoperative rehabilitation will include early knee range-of-motion exercises, non-weight-bearing ambulation initially, and progressive weight-bearing according to clinical and radiological fracture healing.
Rasmussen Knee Functional Score
Functional outcome will be assessed using the Rasmussen Knee Functional Score at the final postoperative assessment. Scores will be categorized as excellent (27-30), good (20-26), fair (10-19), or poor (6-9). The score will be compared between patients treated with hybrid Ilizarov fixation and those treated with locking plate fixation.
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Prof. Sajjad Hussain Goraya
Lead sponsor
Allama Iqbal Medical College
Sponsor institution