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Posterolateral Tibial Plateau Fractures-Does Fixation Choice Matter? A Biomechanical Investigation
Pongsatorn Chailertpongsa1, Sakon Donnimitsakul, Teerawat Laonapakul
1From the Department of Orthopaedics (Dr. Chailertpongsa, Dr. Donnimitsakul, Dr. Thienthong, Dr. Twinprai, Dr. Sripadungkul, Dr. Apinyankul), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; the Department of Industrial Engineering (Dr. Laonapakul), Faculty of Engineering, Khon Kaen University, Khon Kaen, Thailand; the Department of Anatomy (Dr. Samrid), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; and the Department of Orthopaedics (Dr. Phruetthiphat), Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand.
Posterior T-plates and lateral locking compression plates offer superior stability for posterolateral tibial plateau fractures compared to dynamic compression plates, despite similar ultimate failure loads. This research provides biomechanical data for optimizing surgical fixation techniques.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Trauma Surgery
Background:
- Surgical management of tibial plateau fractures aims for anatomic reduction and stable fixation.
- A knowledge gap exists in biomechanical comparisons of fixation techniques for posterolateral fractures.
Purpose of the Study:
- To biomechanically compare three common fixation techniques for posterolateral tibial plateau fractures.
- To provide clinically relevant data for optimizing surgical outcomes.
Main Methods:
- Twelve fresh cadaveric proximal tibiae underwent standardized posterolateral fracture creation.
- Specimens were randomly assigned to posterolateral buttress plating (DCP), T-shaped plating, or lateral locking compression plating (LCP) fixation.
- Biomechanical testing under axial compression until failure (>3 mm displacement) was performed, measuring load tolerance and displacement.
Main Results:
- No significant difference in load-to-failure was found among the three fixation methods (DCP, T-plate, LCP).
- Fragment subsidence varied significantly, with DCP showing greater displacement than T-plate and LCP.
- T-plate and LCP constructs demonstrated superior stability against incremental displacement.
Conclusions:
- Posterior T-plates and lateral locking compression plates provide greater stability than posterior DCP fixation for posterolateral tibial plateau fractures.
- While ultimate failure loads were similar, T-plate and LCP constructs resist displacement more effectively.
