Assessment of Mean American Knee Society Scorefor Complex Plateau Fractures with Llizarov External Fixation


  • Fahad Hassan Medical Officer, Primary and Secondary Health Care department, Punjab
  • Abdul Qadeer Khan Medical officer, Primary and secondary health care department, KPK
  • Wazir Ahmed Assistant Professor, Bolan Medical College Quetta
  • Nadeem Hassan Medical officer, Pakistan Institute of Medical Science, Islamabad
  • Suresh Kumar Associate Professor of Anesthesiology, PIMS, SZABMU, Islamabad
  • Najmuddin Fazlani Senior Registrar Department of orthopaedic surgery BMC, LUMHS/Jamshoro



Tibial Plateau Fractures, Ilizarov, External Fixation, American Knee Society Score


Objective: To determine clinical outcomes based on the AKSS (American Knee Society Score) in patients with complex tibial plateau fractures treated using Ilizarov external fixation.

Methodology: This descriptive case series study was conducted at the Department of Orthopaedics, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from November 2020 to November 2021. The study included patients aged 20 to 55 of both genders with Schatzker type V or VI tibial plateau fractures who underwent Ilizarov external fixation and surgery within one week of the injury. Informed consent was obtained from all patients before undergoing Ilizarov external fixation. Pin tract infections were monitored weekly, and radiological assessments were performed monthly. The decision to remove the fixator was based on evidence of bone healing from two different angles, along with a successful stress test after removing the rods between the first two rings. After the fixator was removed, patients wore a removable brace for 3 to 5 weeks to protect their limbs during weight-bearing. Six weeks after external fixation, patients were assessed for pain levels, knee and ankle range of motion, limb alignment, and functional status according to the AKSS. Data were collected and analyzed using SPSS version 20.

Results: The mean age of the patients was 32.4±8.7 years. Out of all the patients, 66.5% were male, and 33.5% were female. The AKSS score averaged 82.5±11.2, the mean duration of surgery was 41.5±9.3, and the mean range of motion (ROM) was 22.1±4.8. Clinical outcomes were classified as excellent in 47 (27.2%) patients, good in 57 (32.9%), while 48 (27.8%) and 21 (12.1%) had fair and poor clinical outcomes, respectively.

Conclusion: The Ilizarov external fixation technique appears to be a reasonably effective method for treating complex tibial plateau fractures.






Original Articles