title: Biomechanical superiority of plate fixation for proximal tibial osteotomy.
abstract: Proximal tibial osteotomies require secure and durable fixation to allow early range of motion; however, biomechanical data comparing commonly used fixation methods are lacking. The current study was done to quantify the dynamic biomechanical performance of blade staple fixation and plate fixation of simulated proximal tibial osteotomies. A 15 degrees proximal tibial osteotomy was done on each of 18 synthetic adult composite tibias. Blade staples were used as the means of fixation in nine tibias; plate fixation was used in the remaining nine tibias. The specimens were stressed cyclically in sinusoidal loading whose peak compression and tension loads imitate those measured during normal gait. Device performance was quantified by measuring displacement at the osteotomy site and the number of cycles to failure. Plate fixation had a greater fatigue life than staples (eight plates surviving past 200,000 cycles versus one blade staple) and showed a trend toward less displacement (0.69 mm versus 0.97 mm). Plate fixation of proximal tibial osteotomies offers better fixation and dynamic mechanical performance than blade staples.
authors.affiliation: Division of Orthopaedic Surgery, University of Kentucky Medical Center, Lexington, USA. hartfor@uky.edu
authors.forename: James M
authors.initials: JM
authors.lastname: Hartford
authors.forename: Peter
authors.initials: P
authors.lastname: Hester
authors.forename: Phil M
authors.initials: PM
authors.lastname: Watt
authors.forename: Doris
authors.initials: D
authors.lastname: Hamilton
authors.forename: Michael
authors.initials: M
authors.lastname: Rohmiller
authors.forename: David
authors.initials: D
authors.lastname: Pienkowski
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D001860:Bone Plates; D001863:Bone Screws / Q000009:adverse effects; D019544:Equipment Failure Analysis; D015775:Fractures, Stress / Q000209:etiology; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects; D010027:Osteotomy / Q000295:instrumentation* / Q000379:methods; D016059:Range of Motion, Articular; D017792:Surgical Stapling / Q000379:methods; D013977:Tibia / Q000601:surgery*