title: Biomechanical analysis of posteromedial tibial plateau split fracture fixation.
abstract: The purpose of this study was to compare the biomechanical strength of four different fixation methods for a posteromedial tibial plateau split fracture. Twenty-eight tibial plateau fractures were simulated using right-sided synthetic tibiae models. Each fracture model was randomly instrumented with one of the four following constructs, anteroposterior lag-screws, an anteromedial limited contact dynamic compression plate (LC-DCP), a lateral locking plate, or a posterior T-shaped buttress plate. Vertical subsidence of the posteromedial fragment was measured from 500 N to 1500 N during biomechanical testing, the maximum load to failure was also determined. It was found that the posterior T-shaped buttress plate allowed the least subsidence of the posteromedial fragment and produced the highest mean failure load than each of the other three constructs (P=0.00). There was no statistical significant difference between using lag screws or an anteromedial LC-DCP construct for the vertical subsidence at a 1500 N load and the load to failure (P>0.05). This study showed that a posterior-based buttress technique is biomechanically the most stable in-vitro fixation method for posteromedial split tibial plateau fractures, with AP screws and anteromedial-based LC-DCP are not as stable for this type of fracture.
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital affiliated to Shanghai JiaoTong University, 600 Yisan Road. Shanghai, 200233, PR China.
authors.forename: Zhi-Min
authors.initials: ZM
authors.lastname: Zeng
authors.forename: Cong-Feng
authors.initials: CF
authors.lastname: Luo
authors.forename: Sven
authors.initials: S
authors.lastname: Putnis
authors.forename: Bing-Fang
authors.initials: BF
authors.lastname: Zeng
mesh_terms: D001696:Biomechanical Phenomena; D001860:Bone Plates; D001863:Bone Screws; D003198:Computer Simulation; D019544:Equipment Failure Analysis; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008954:Models, Biological; D013314:Stress, Mechanical; D013977:Tibia / Q000293:injuries / Q000503:physiopathology / Q000601:surgery*; D013978:Tibial Fractures / Q000503:physiopathology / Q000601:surgery*