Biomechanical comparison of two locking plate systems for the distal tibia

Area of Science:

• Orthopedic surgery
• Biomechanics
• Traumatology

Background:

• Distal tibia fractures present stabilization challenges, often leading to nonunions due to fragment instability.
• Evaluating different locking plates is essential for optimizing fixation in comminuted distal tibia fractures.

Purpose of the Study:

• To biomechanically compare the stiffness and interfragmentary movement of the AxSOS and LCP locking plates in simulated comminuted distal tibia fractures.

Main Methods:

• A biomechanical study comparing a locked medial plate (AxSOS) and a locked medial plate (LCP) for distal tibia fractures.
• Simulated comminuted fractures with a 10 mm gap were subjected to compression (350 N) and torsional (0-10 Nm) loads.
• Stiffness and interfragmentary movement were measured using machine data and an optoelectronic device.

Main Results:

• Under compression, both plates showed similar stiffness, but the AxSOS plate exhibited significantly less interfragmentary movement (0.6 mm vs. 1.03 mm for LCP).
• In torsional testing, the AxSOS plate demonstrated significantly higher stiffness compared to the LCP.
• Interfragmentary movement was comparable between the AxSOS and LCP plates under torsional load.

Conclusions:

• The angle-stable medial AxSOS plate provides superior biomechanical performance over the locked medial plate (LCP) for distal tibia fracture fixation.
• The AxSOS plate's reduced interfragmentary movement and increased stiffness are advantageous for treating complex distal tibia fractures.
• Steel plates are recommended for distal tibia plating from a biomechanical perspective.