A biomechanical comparison of three different lateral tibia locking plates.

Area of Science:

• Orthopedic surgery
• Biomechanical engineering
• Trauma surgery

Background:

• Schatzker V tibial plateau fractures are complex injuries requiring robust surgical fixation.
• Lateral locking plates are commonly used, but their efficacy in supporting the medial plateau under axial load needs further investigation.

Purpose of the Study:

• To evaluate the mechanical performance of three laterally placed proximal tibia locking plates in supporting the medial plateau of Schatzker V tibial plateau fractures during axial loading.
• To compare the load-bearing capacity and failure modes of Synthes, Zimmer, and DePuy plates.

Main Methods:

• Sawbone tibia models were used to create Schatzker V fractures.
• Three groups of five tibias each were plated with Synthes 4.5-mm LCP, Zimmer NCB, or DePuy Polyax plates.
• Axial loading was applied to the medial plateau using a servohydraulic testing machine, measuring subsidence and load to failure.

Main Results:

• The Synthes and DePuy plates carried significantly more load at 2 mm and 3 mm of subsidence compared to the Zimmer plate.
• The DePuy plate demonstrated the highest load to failure (2051.2 N), statistically outperforming both Synthes (1724.8 N) and Zimmer (1724.8 N) plates.
• All tested plates exceeded physiological forces required for weight-bearing.

Conclusions:

• Lateral tibia locking plates provide adequate support for the medial plateau in Schatzker V fractures.
• The DePuy Polyax and Synthes LCP plates offer superior mechanical support compared to the Zimmer NCB plate under axial loading.
• All evaluated plates are suitable for treating Schatzker V tibial plateau fractures, with DePuy and Synthes showing enhanced performance.