Background: Tibial plateau fractures (TPF) are complex intra-articular injuries that account for 1–2% of all fractures. High-energy Schatzker type V–VI fractures are particularly difficult to manage because of comminution, soft-tissue compromise, and a high risk of postoperative complications. The Ilizarov-type circular external fixator has been proposed as a valuable alternative to open reduction and internal fixation (ORIF) in the management of such injuries, especially in patients with severe soft-tissue damage. This technique is preferred because it requires a smaller surgical incision, is associated with lower rates of deep infection, enables accurate restoration of the lower-limb mechanical axis, and allows early mobilization.Aims: This study aimed to evaluate the long-term clinical and radiological outcomes of patients with high-energy Schatzker type V–VI TPF treated with Ilizarov-type external fixator osteosynthesis.Methods: This single-center retrospective study included 42 patients (43 knees) with high-energy type V–VI fractures treated using Ilizarov-type external fixation. Demographic data, fracture patterns, complications, and functional and radiological outcomes were analyzed. The Knee Society Knee Score (KSKS) was used for functional evaluation, and post-traumatic osteoarthritis was gradedradiographically.Results: The mean follow-up was 36 months. Pin tract infection occurred in 57.1% of patients and was the most common complication. Anatomical reduction was achieved in 23.3% of cases. Functional results were excellent or good in 65%, and osteoarthritic changes were absent in 23.3%.Conclusions: Circular external fixation with minimal internal fixation provides a stable construct and satisfactory long-term outcomes in high-energy Schatzker type V–VI TPF. Although reduction loss and suboptimal anatomical alignment remain the main limitations, this technique minimizes deep infection risk and preserves soft-tissue integrity, making it a reliable option for complex fractures.
Karahan et al. (Tue,) studied this question.