Comparison of External and Internal Fixation for Management of Bicondylar Tibial Plateau Fractures in Terms of Surgical Site Infection

Muhammad Javaid Iqbal; Afzal Javid; Shahzad Mahmood Shahid; Fida Hussain; Allah Rakha

doi:10.29054/apmc/2020.740

Muhammad Javaid Iqbal Professor & Head of Orthopedics, FMU / DHQ Hospital, Faisalabad Pakistan
Afzal Javid Senior Registrar, Orthopedics, DHQ Hospital, Faisalabad Pakistan
Shahzad Mahmood Shahid Senior Registrar, Orthopedics, DHQ Hospital, Faisalabad Pakistan
Fida Hussain Medical Officer, Orthopedics Govt. General Hospital, Samanabad Faisalabad Pakistan
Allah Rakha Senior Registrar, Orthopedics, DHQ Hospital, Faisalabad Pakistan

DOI: https://doi.org/10.29054/apmc/2020.740

Keywords: Tibial plateau fractures, Bicondylar (type V & VI), External fixation, Internal fixation, Surgical site infection

Abstract

Objective: To compare external and internal ﬁxation for the management of bicondylar tibial plateau fractures in terms of surgical site infection (SSI). Study Design: Randomized Controlled Trial. Settings: Faisalabad Medical University and affiliated Hospitals, Faisalabad, Pakistan. Duration: May 15, 2017 to November 15, 2017. Methodology: Approval from the institutional ethical committee was taken. All the patients with diagnosis of Bicondylar (Schatzker types V and VI) tibial plateau fractures in acute trauma setting who fulfilled the selection criteria were entered in the study by taking informed written consent. All selected cases were guided/informed regarding risk and benefits of the procedure. Randomization was based on computer generated numbers and allotted A & B groups. Group A patients underwent open reduction and internal fixation and in Group B patients’ external fixation with illizarove ring fixator was applied. All the relevant information was filled on predesigned Performa. Post-operative superficial surgical site infection was noted at 4 weeks after surgery in the ward of each patient. According to the Centre of Disease Control and prevention (CDC) and Healthcare Infection Control Practices Advisory Committee (HICPAC) criteria for defining a superficial surgical site infection, the record from each patient was collected after carefully examining the surgical wound at 4 weeks after surgery. Results: Post-operative superficial surgical site infection was 10 %(n=4) in cases of Group-A and 47.5%(n=19) in cases of Group-B, whereas 90%(n=36) in Group-A and 52.5%(n=21) in Group-B had no SSI. Conclusion: We found lower rate of infection in cases treated with internal fixation than those undergoing external fixation for bicondylar tibial plateau fractures.