Fixation of Tibial Plateau Fractures Type 5,6 by Ilizarov Apparatus: A Systematic Review of Outcomes and Complications

Abstract

Abstract Background Complex proximal tibial fractures especially tibial plateau are one of the most challenging problems in fracture surgery. Treatment of complex tibial plateau fractures remains difficult. The soft tissue component to the injury necessitates careful timing of surgical fixation in order to minimize wound complications. Objective To compare the 2 Methods of fixation in management of Tibial plateau fractures (Schatzker type V & VI) as regards many aspects including but not limited to; superficial infection, deep infection, osteoarthritis, Functional & Radiological outcome, compartemental syndrome& postoperative stiffness. Patients and Methods Search results was conducted to systematic review management software and manually screened for eligibility to be included. Comparing Ring fixator and ORIF in outcomes and complications for treatment of high-energy fractures (Schatzker type V&VI) of the proximal tibia. Results The results showed that Ilizarov had a higher proportion of cases with excellent functional results compared to ORIF (57.1% vs 24.3%). In addition, the proportion of cases with poor functional results was lower in the Ilizarov group compared to the ORIF group (6.1% vs 25.7%). This revealed a significant difference between the two surgical techniques (p-value = 0.001), indicating that Ilizarov was associated with better functional outcomes compared to ORIF. These findings suggest that Ilizarov may be a more effective surgical technique for achieving better functional outcomes in patients with limb injuries. However, it is important to note that the included studies had some limitations, such as small sample sizes and potential biases. Further studies with larger sample sizes and more rigorous methodologies are needed to confirm these findings and to provide more conclusive evidence on the comparative effectiveness of Ilizarov and ORIF. Data Sources Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2022. Conclusion This meta-analysis reviewed and compared the outcomes of two different surgical techniques, Ilizarov and ORIF, in treating limb injuries. The results showed that there was no statistically significant difference between the two techniques in terms of superficial infection, deep infection, osteoarthritis, compartmental syndrome, and stiffness. However, ORIF had a faster time to radiographic union compared to Ilizarov. In terms of functional outcomes, Ilizarov was associated with better outcomes compared to ORIF. These findings suggest that Ilizarov may be a more effective technique for achieving better functional outcomes in patients with limb injuries. Nonetheless, the limitations of the included studies need to be considered, and further research with more robust methodologies is necessary to confirm these findings.