"FUNCTIONAL & RADIOLOGICAL OUTCOMES OF KNEE JOINT AFTER SURGICAL TREATMENT OF PROXIMAL TIBIAL FRACTURES WITH HYBRID EXTERNAL FIXATOR"

Abstract

BACKGROUND:

The major cause of Proximal Tibial Fractures especially Schatzker Type 5 & 6 is high energy trauma. These are challenging to the orthopaedic surgeon & are the result of extensive angular and axial forces causing impaction and comminution of articular surface. In 15-30 % of cases these are Schatzker Type 5&6 injuries. Treatment for these fractures using a hybrid external fixator is an appropriate choice.

OBJECTIVES:

To determine the Functional & Radiological outcomes of Knee joint in Schatzker Type 5&6 Proximal Tibial fractures treated with Hybrid External Fixator.

STUDY DESIGN: Prospective observational study

STUDY SETTING: Department of Orthopedic Surgery Services Hospital Lahore

INCLUSION CRITERIA: All adult patients in between age of 21-70 years having Schatzker Type 5 & 6 Proximal Tibial Fractures

EXCLUSION CRITERIA:   Patients having Polytrauma, Patients having associated Head & Spinal injury &

Patients having previous injuries around the Knee joint were excluded from the study.

METHODOLOGY:

This prospective observational study was conducted Department of Orthopedic Surgery, Services Hospital Lahore from September 2018 to April 2020 after permission from Hospital Ethical Review Board. A total number of 60 patients with age range in between 18-70 years having Schatzker Type 5&6 Proximal Tibial fractures were included in the study. Forty patients had Type 5 while remaining 20 had Type 6 fractures. All these patients underwent X-Rays of Knee joint, both Anteroposterior (AP) & Lateral (Lat) views. In all these patients we applied 2 rings Hybrid External Fixator. All patients were followed for a period of one year after the surgery and functional & Radiological outcomes was evaluated with Rasmussen Score.

RESULTS:

At the end of final follow-up Functional Rasmussen Score was excellent in 12 patients, good in 45 patients was fair in 03 patients. Mean time for bony union was 14.2 weeks. Radiological Rasmussen Score was excellent in 24 patients, good in 32 patients and was fair in 04 patients.

CONCLUSION:

Hybrid External Fixator is a good and valid option to treat Schatzker fractures especially Type 5&6 injuries in the presence of extensive soft tissue disruption. It results in good functional & radiological outcomes.

KEY WORDS:

Proximal Tibial Fractures, Schatzker Classification, Schatzker Type 5 & 6, Hybrid External Fixator