Without Knife: Healing Schatzker I Tibial Plateau Fracture through Integrative Care

Abstract

Tibial plateau fractures are complex intra-articular injuries commonly managed surgically to restore joint congruity and stability; however, operative treatment is associated with notable complication rates, particularly in elderly and comorbid patients. Schatzker Type I fractures, when stable and minimally displaced, may be amenable to conservative management in carefully selected cases. We report a case of a 65-year-old male with a closed Schatzker Type I tibial plateau fracture following a road traffic accident, who declined surgical intervention due to concerns regarding postoperative risks. The patient was managed non-operatively using a structured orthopaedic–Ayurvedic approach comprising plaster immobilization with strict non-weight bearing, staged rehabilitation, and internal and external Ayurvedic therapies based on principles of Bhagna Chikitsa. Clinical and radiological follow-up demonstrated progressive fracture healing with satisfactory callus formation. Functional outcomes showed marked improvement, with knee range of motion improving from complete restriction at presentation to 100° of flexion with full extension after 12 weeks, along with restoration of independent ambulation. No complications such as fracture displacement, infection, instability, or disabling stiffness were observed. This case highlights that individualized conservative management can result in favourable clinical, radiological, and functional outcomes in selected Schatzker Type I tibial plateau fractures, particularly in elderly or medically compromised patients, and underscores the potential role of integrative orthopaedic–Ayurvedic care as a viable non-operative alternative.