A biomechanical analysis of internal fixation of complex tibial plateau fractures

被引:99
作者
Horwitz, DS [1 ]
Bachus, KN
Craig, MA
Peters, CL
机构
[1] Univ Utah, Orthoped Bioengn Res Lab, Salt Lake City, UT 84112 USA
[2] Univ Utah, Sch Med, Dept Orthoped, Salt Lake City, UT USA
关键词
tibial plateau; fracture; antiglide plate; buttress plate; biomechanics;
D O I
10.1097/00005131-199911000-00005
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Objective: To compare the mechanical stability of fixation of an unstable bicondylar tibial plateau fracture with several different fixation techniques in a cadaveric model. Design: Randomized laboratory investigation using a simulated bicondylar tibial plateau fracture with metaphyseal-diaphyseal dissociation. Setting: Complex tibial plateau fractures were instrumented and tested under ramp and cyclic loading conditions on a servohydraulic materials testing machine. Intervention: Each tibia was instrumented sequentially with a lateral buttress plate, a lateral and a medial buttress plate, and a lateral buttress and an anteromedial antiglide plate for ramp load resting. For cyclic testing, one of the three constructs was used on each specimen. Main Outcome Measurements: Vertical subsidence of the medial tibial plateau was measured in both ramp and cyclic loading in order to evaluate the three internal fixation techniques. Results: No significant difference was measurable between the dual buttress construct and the lateral buttress/anteromedial antiglide construct. However, the lateral buttress plate alone provided significantly less stability. Conclusions: A lateral buttress plate with an anteromedial antiglide plate may provide equally effective fixation as compared with the dual buttress plating technique in complex tibial plateau fractures. This less invasive technique may also be associated with fewer complications due to the lack of soft tissue stripping that is required for its application.
引用
收藏
页码:545 / 549
页数:5
相关论文
共 18 条
[1]
BLAND M, 1996, INTRO MED STAT, P1
[2]
BLOKKER CP, 1984, CLIN ORTHOP RELAT R, V182, P193
[3]
DECOSTER TA, 1988, CLIN ORTHOP RELAT R, P196
[4]
Treatment of high-energy tibial plateau fractures by the Ilizarov circular fixator [J].
Dendrinos, GK ;
Kontos, S ;
Katsenis, D ;
Dalas, A .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1996, 78B (05) :710-717
[5]
Gaudinez RF, 1996, CLIN ORTHOP RELAT R, P203
[6]
Infections in periarticular fractures of the lower extremity treated with tensioned wire hybrid fixators [J].
Hutson, JJ ;
Zych, GA .
JOURNAL OF ORTHOPAEDIC TRAUMA, 1998, 12 (03) :214-218
[7]
Split fracture of the lateral tibial plateau: Evaluation of three fixation methods [J].
Koval, KJ ;
Polatsch, D ;
Kummer, FJ ;
Cheng, DY ;
Zuckerman, JD .
JOURNAL OF ORTHOPAEDIC TRAUMA, 1996, 10 (05) :304-308
[8]
MICROMOTION SECONDARY TO AXIAL, TORSIONAL, AND SHEAR LOADS IN 2 MODELS OF CEMENTLESS TIBIAL COMPONENTS [J].
KRAEMER, WJ ;
HARRINGTON, IJ ;
HEARN, TC .
JOURNAL OF ARTHROPLASTY, 1995, 10 (02) :227-235
[9]
EXTERNAL FIXATION AND LIMITED INTERNAL-FIXATION FOR COMPLEX FRACTURES OF THE TIBIAL PLATEAU [J].
MARSH, JL ;
SMITH, ST ;
DO, TT .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1995, 77A (05) :661-673
[10]
MURPHY CP, 1991, ORTHOPEDICS, V14, P273