Schatzker V-VI fractures of tibial plateau healed fast within 3.5 months: Ilizarov fixation with 6 weeks femoral ring offload

Background: Schatzker V and VI tibial plateau fractures with significant soft-tissue injury, the Ilizarov circular fixator provides essential, stable fixation while minimizing further disruption. A key advantage is the staged removal of the distal femoral ring, which allows for earlier knee mobilization and is critical for preserving long-term joint function. To evaluate the effectiveness of a three-and-a-half-month union strategy using Ilizarov fixation with distal femoral ring removal at six weeks in patients with Schatzker type V and VI tibial plateau fractures. Methods: This prospective cohort study was conducted at Department of Orthopedics, National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka, Bangladesh, Bangladesh, from January 2023 to December 2024. A 41-patient cohort undergoing Ilizarov fixation with femoral ring removal at six weeks was assessed for union, knee motion, alignment, weight-bearing, and complications. Data analysis was performed using SPSS version 23.0 to evaluate these outcomes. Results: The study cohort (mean age 38.6±9.4 years, 70.7% male) showed favorable outcomes. Radiological union was achieved in 87.8% of patients at a mean of 14.2±1.6 weeks, with 90.2% maintaining acceptable alignment. Final mean knee flexion was 118°±12°. Complications included pin-tract infection (14.6%) and stiffness (9.8%), with no deep infections or non-unions. Conclusions: Ilizarov fixation with planned distal femoral ring removal at six weeks is an effective strategy for managing Schatzker type V and VI tibial plateau fractures, promoting early union, functional recovery, and low complication rates.