title: Biomechanical comparison of plate-screw and screw fixation in medial tibial plateau fractures (Schatzker 4). A model study.
abstract: BACKGROUND
  The objective of this biomechanical study was to compare the respective efficiency of plate-screw fixation and screw fixation in an experimental model of a Schatzker type 4 fracture.
  
  
  OBJECTIVE
  screw fixation and plate fixation have a similar load to failure.
  
  
  METHODS
  This study compares the stability of Schatzker type 4 medial tibial plateau fractures fixed with either 36.5mm cancellous bone screw with a 16 mm threaded segment or with six-holed buttress T-plate-screw system. A Schatzker type 4 fracture was modeled on an artificial bone model. In a first group of 10 fracture models, following the anatomical reduction, fractures were stabilized with screws with washers. In the second group, of 10 fracture models, fractures were stabilized with T-plate. After fixation ascending axial compression was applied on bone models (Instron machine).
  
  
  RESULTS
  Load bearing capacity was 1397.6+/-194.4N in the Group 1 and 2153.2+/-204.4N in the Group 2. The difference between the two groups was statistically significant (p<0.001).
  
  
  CONCLUSIONS
  According to this result, experimental load bearing of bone models indicate that plate-screw fixation system has a significantly higher stabilization capacity than fixation with three screws alone. Our hypothesis was not confirmed. In order to maintain anatomical repositioning, plate-screw system is a more stable fixation method than the screw in medial tibial plateau fractures Schatzker 4 LEVEL OF EVIDENCE: 1.
authors.affiliation: Goztepe Training and Research Hospital, Department of Orthopaedics and Traumatology, Bostanci mah. Mehmet Sevki Pasa cd. Isik apt. 32/12 Istanbul, Turkey. hakanturancift@yahoo.com
authors.forename: H
authors.initials: H
authors.lastname: Cift
authors.forename: O
authors.initials: O
authors.lastname: Cetik
authors.forename: B
authors.initials: B
authors.lastname: Kalaycioglu
authors.forename: M H
authors.initials: MH
authors.lastname: Dirikoglu
authors.forename: K
authors.initials: K
authors.lastname: Ozkan
authors.forename: F
authors.initials: F
authors.lastname: Eksioglu
mesh_terms: D001696:Biomechanical Phenomena; D001860:Bone Plates; D001863:Bone Screws; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D008953:Models, Anatomic; D013978:Tibial Fractures / Q000601:surgery*; D016474:Weight-Bearing