A Dual-Thread Lag-Locking Screw Enhances Single Lateral Plate Fixation in Bicondylar Tibial Plateau Fractures: A...

Area of Science:

• Orthopedic surgery
• Biomechanical engineering
• Trauma research

Background:

• Schatzker type V bicondylar tibial plateau fractures are complex and challenging to treat.
• Minimally invasive fixation strategies often struggle to achieve adequate stability.
• Current treatments may require more invasive approaches like dual plating.

Purpose of the Study:

• To introduce and evaluate a novel dual-thread lag and locking plate (DLLP) for tibial plateau fractures.
• To compare the biomechanical performance of DLLP against conventional single lateral locking plates (SLLPs).
• To assess the potential of DLLP as a less invasive fixation option.

Main Methods:

• Utilized a custom-built compression evaluation platform.
• Employed standardized 3D-printed fracture models of Schatzker type V tibial plateau fractures.
• Conducted static and dynamic fatigue testing to assess construct performance.
• Measured interfragmentary compression, maximum failure force, and fatigue life.

Main Results:

• DLLP generated significant interfragmentary compression (1.22 mm) compared to SLLP (0.02 mm).
• DLLP exhibited a greater maximum failure force (7801.51 N vs. 6224.84 N) and improved resistance to lateral displacement.
• All DLLP constructs survived 1 million dynamic fatigue cycles, while SLLP constructs failed prematurely.

Conclusions:

• Lag screw compression is crucial for maintaining fracture stability in tibial plateau injuries.
• The DLLP design offers superior biomechanical performance over SLLPs.
• DLLP presents a promising, less invasive alternative for treating complex tibial plateau fractures.