A Biomechanical Comparison Study of Plate-Nail and Dual-Plate Fixation in AO/OTA 41-C2 Tibial Plateau Fractures

This study's purpose was to evaluate the biomechanical performance of plate-nail and dual-plate fixation for the treatment of AO/OTA 41-C2 tibial plateau fractures.

Twenty synthetic tibias were selected and randomly divided into a plate-nail group (n = 10) and a dual-plate group (n = 10). After the artificial tibias were osteotomized to simulate AO/OTA 41-C2 tibial plateau fractures in both groups, the plate-nail and the dual-plate methods, respectively, were used for fixation, and then axial compression loading, three-point bending, torsion, and axial failure tests were carried out. The data of each group were recorded and statistically analyzed.

In the axial compression test, the average stiffness of the plate-nail group was higher than that of the dual-plate group (p < 0.05). The displacement generated in the plate-nail group was significantly smaller than that in the dual-plate group (p < 0.05). In the resisting varus test, the stress of the plate-nail group was significantly higher than that of the dual-plate group (p < 0.05). In the resisting valgus test, the stress of the plate-nail group was slightly higher than that of the dual-plate group, but the difference was not statistically significant (p > 0.05). In the static torsion test, the load applied to the plate-nail group was smaller than that of the dual-plate group when rotated to 5° (p < 0.05). In the axial compression failure test, the average ultimate load of the plate-nail group was significantly higher than that of the dual-plate group (p < 0.05).

The treatment of AO/OTA 41-C2 tibial plateau fractures with plate-nail fixation is superior to that with dual-plate fixation in resisting axial stress and preventing tibial varus deformity, while dual-plate fixation has better resisting torsional ability.