A biomechanical comparison of three different lateral tibia locking plates

The purpose of this study was to determine how well laterally placed modern tibia locking plates used in the treatment of Schatzker V tibial plateau fractures would uphold the medial plateau during axial loading. Fifteen third generation Sawbone tibias were obtained and an osteotomy was cut beneath the medial plateau to recreate Schatzker V type plateau fractures. Three groups were created (n=5 per group). Each group was plated with either a Synthes 4.5-mm LCP proximal tibial plate, a Zimmer NCB proximal tibia plate, or a DePuy Polyax tibial plate. A vertical load was applied over the medial plateau using an Instron servohydraulic test machine. Load measurements were analyzed at 2 and 3 mm of subsidence as well as load to failure. Failure was defined as closure of the wedge osteotomy or the medial condyle collapsing. A statistical difference was noted between the 2 plates from Synthes and DePuy and the plate from Zimmer with load carried at 2 and 3 mm of subsidence (Synthes 640.4 N & 943.7 N, Depuy 607.4 N & 891.0 N, Zimmer 459.7 N & 643.2 N). At failure, DePuy (2051.2 N) was statistically stronger than both Synthes (1724.8 N) and Zimmer (1724.8 N). The Synthes and DePuy plates both held up better than the Zimmer plate at 2 and 3 mm of subsidence. Despite this fact, all plates tested held up well above physiological forces of full and partial weight bearing and therefore would be appropriate for the treatment of Schatzker V type tibial plateau fractures.