Assessment of Functional Outcome from the Hybrid Illizarov Technique in Patients with Complicated Tibial Plateau Fractures

A. H. M. Abdul Wahid *

Department of Orthopaedics, North Bengal Medical College and Hospital, Sirajgonj, Bangladesh.

Md. Ziaur Rahman

Department of Surgery, North Bengal Medical College and Hospital, Sirajgonj, Bangladesh.


Opthalmology, Guk Eye Hospital, Bogura, Bangladesh.

Abdul Alim Shaikh

Department of Surgery, North Bengal Medical College and Hospital, Sirajgonj, Bangladesh.

*Author to whom correspondence should be addressed.


Background: Complex tibial plateau fractures pose challenges in orthopedic trauma care due to their intricate nature, potential for functional impairment, and involvement of articular disruption, metaphyseal comminution, and soft tissue injuries. Restoring joint alignment and ligament stability is crucial for favorable outcomes. Surgical methods like the Illizarov technique and its adaptations have gained attention. Existing literature reports around 50% satisfactory results regardless of closed or operative approaches. Failures result in pain, limited motion, deformities, and knee instability. Ilizarov's circular fixator is valuable for high-energy fractures with compromised soft tissues, offering stability and indirect reduction.

Aim of the Study: This study evaluates the hybrid Illizarov technique's outcomes in restoring structure and function for complex tibial plateau fractures.

Methods: This was a retrospective study. The study was conducted at the department of Orthopedics in North Bengal Medical College and Hospital, Sirajgonj, Bangladesh.  One hundred and fifty-two patients were prospectively recruited with knee osteoarthritis over one year of the study period from January 2020 to December 2022.

Results: The study used the hybrid Ilizarov technique to investigate 27 patients who underwent surgical treatment for complex tibial plateau fractures. Most patients (74.07%) were aged 20-40, with the rest (25.93%) aged 41-60. Males made up 81.48% of participants, while females were 18.52%. BMI distribution showed that 44.44% had normal BMI, 29.63% were overweight, and 11.11% were obese. More injuries occurred on the right side (59.26%). Complications affected 44.44% of patients, including pin tract infections (22.22%) and joint stiffness (7.41%). Clinical outcomes varied, with around 60% achieving good outcomes, 25.93% excellent, 7.41% fair, and a similar number of poor.

Conclusion: The Hybrid Illizarov Technique demonstrates promise in addressing complicated tibial plateau fractures, showcasing favorable functional outcomes. This approach can potentially enhance patient recovery and warrants further exploration in orthopedic practice.

Keywords: Functional outcome, tibia plateau fracture, hybrid ilizarov

How to Cite

Wahid, A. H. M. A., Rahman, M. Z., Noor-e-Tahrima, & Shaikh, A. A. (2023). Assessment of Functional Outcome from the Hybrid Illizarov Technique in Patients with Complicated Tibial Plateau Fractures. Asian Journal of Orthopaedic Research, 6(2), 97–103. Retrieved from


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El Barbary H, Abdel Ghani H, Misbah H, Salem K. Complex tibial plateau fractures treated with Ilizarov external fixator with or without minimal internal fixation. International orthopaedics. 2005 Jun;29:182-5.

Mohamed OA, Youssef SA. Treatment of high-energy tibial plateau fractures by the Ilizarov circular fixator. Medical Journal of Dr. DY Patil University. 2013 Jan 1;6(1):33-41.

Lansinger O, Bergman B, Körner L, Andersson GB. Tibial condylar fractures. A twenty-year follow-up. JBJS. 1986 Jan 1;68(1):13-9.

Sirkin MS, Bono CM, Reilly MC, Behrens FF. Percutaneous methods of tibial plateau fixation. Clinical Orthopaedics and Related Research®. 2000 Jun 1;375:60-8.

Jafree SB, Siddiqui W. Functional Outcome of Hybrid Illizarov Technique in patients with Complex Tibial Plateau Fractures. Pakistan Journal of Medical & Health Sciences. 2022 Nov 11;16(10):6-.

Hall JA, Beuerlein MJ, McKee MD. Open reduction and internal fixation compared with circular fixator application for bicondylar tibial plateau fractures: Surgical technique. JBJS. 2009 Mar 1;91(Supplement_2_Part_1):74-88.

Ferreira N, Senoge ME. Functional outcome of bicondylar tibial plateau fractures treated with the Ilizarov circular external fixator. SA Orthopaedic journal. 2011 Jan;10(3):80-4.

Rose R. Acute trauma applications of the ilizarov method. Intern J OrthopSurg. 2010;16:38-43.

Raza A, Kumar S, Kumar D, Qadir A, Muzzammil M, Lakho MT. Complex tibial plateau fractures: primary fixation using the Ilizarov external fixator. A two-year study at civil hospital Karachi, Pakistan. Cureus. 2019 Aug 13;11(8).

Sureshkumar A, Samynathan G, Anandan H. Analysis of functional outcome of complex tibial plateau fractures (schatzker type 5 and type 6) treated with hybrid external fixators. International Journal of Scientific Study. 2016;4(7):156-8.

Marsh JL, Smith ST, Do TT. External fixation and limited internal fixation for complex fractures of the tibial plateau. JBJS. 1995 May 1;77(5):661-73.

Bear J, Rollick N, Helfet D. Evolution in management of tibial pilon fractures. Current reviews in musculoskeletal medicine. 2018 Dec;11:537-45.

Reddy SR, Shah HM, Godhasiri P. Outcome of tibial plateau fractures treated by hybrid and Ilizarov external fixation. International Journal of Research in Orthopaedics. 2019 Sep;5(5):894.

Jeelani A, Arastu MH. Tibial plateau fractures–review of current concepts in management. Orthopaedics and Trauma. 2017 Apr 1;31(2):102-15.

Kateros K, Galanakos SP, Kyriakopoulos G, Papadakis SA, Macheras GA. Complex Tibial Plateau Fractures Treated by Hybrid External Fixation System: A correlation of followup computed tomography derived quality of reduction with clinical results. Indian journal of orthopaedics. 2018 Apr;52:161-9.

Nawaz SH, Afghan S, Lodhi RI. Outcome of Using Hybrid Ilizarov External Fixator in The Treatment of Schatzker Type V and VI Tibial Plateau Fracture. PJMHS. 2017 Jan 1;11(1):432-4.

Dennan S. Difficulties in the radiological diagnosis and evaluation of tibial plateau fractures. Radiography. 2004 May 1;10(2):151-8.