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Introduction: Bicondylar tibia fractures are mostly treated by ORIF in a staged manner and involve lot of periosteal stripping and soft tissue disruption with potential complications of infection, hardware failures, compartment syndrome and delayed ambulation. Trans-osseous osteosynthesis using Ilizarov ring fixator seems to be a better emerging option for treating such fractures with minimal complications and better clinical and functional outcome. The aim of this study is to evaluate the role of Ilizarov ring fixator in Schatzker type V and VI fractures of proximal tibia. Methods: 30 patients with these injuries were included in the study after careful inclusion and exclusion criteria. All underwent standard Ilizarov ring fixation method with trans-fixation of knee in type VI fractures, which was removed at around 3 -4 weeks and knee mobilization was started. Early weight bearing was encouraged in all cases except two with humerus fracture. Clinical followup was done at monthly intervals along with radiological evaluation. Pin site care was repeatedly stressed for and taught. Final follow up was done at six months post frame removal and Karlstrom-Olerud scoring system was used to analyze the final outcome. Results: There was no incidence of superficial or deep infection. All the fractures healed in time. Incidence of pin tract infection was 26.6% but it resolved with proper dressings and antibiotics. Average union time was around 17.46 weeks. There was no incidence of deep vein thrombosis or compartment syndrome or peroneal nerve injury. Overall result was Excellent in 12 cases, Good in 11 cases, Fair in 4 cases and Poor in 3 cases. Conclusion:Ilizarov fixator is a good, reliable and easily reproducible method of treating such fractures with early return to pre-injury levels in most of the cases.

Introduction: Trimalleolar fracture fixation has undergone a sea change in the recent times. Posterior malleolus component used to be fixed by anteroposterior approach which has not been optimum as far as results are concerned. Posterolateral approach has been well described in literature but very few are using it. This study has tried to evaluate the results of this approach. Methods: Total 32 patients were included in this study. They underwent posterolateral approach and fixation of fibular fracture and posterior malleolus fracture in prone position . Medial malleolus fracture was fixed in supine position. Posterior malleolus was classified based on Haraguchi classification on CT scan. Final evaluation was done using Olerud and Molander scoring system. Results: All fractures united within three months duration. Excellent results were seen in 40.6%, Good in 43.8%, Fair in 9.4% and Poor in 6.2% cases. Most of the patients could return to pre-injury work levels by six months. Conclusion: Direct posterolateral approach allows fixation of fibula and anatomical restoration of ankle joint congruity and syndesmotic stability also, obviating the need of syndesmotic screw. Posterior malleolus fixation is essential in tri-malleolar fractures for good functional outcome.

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