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Biodynamics of internal fixation using inner-side supporting board plus "raft" locking plate and fixation using lateral "T" shaped plate for complex tibial plateau fracture

Xuecheng Sun, Zhiqiang Wang, Jianqin Ji, Wenshuai Zhu, Peiliang Zhang

This study aimed to investigate the biomechanical characteristics of internal fixation using inner-side supporting board plus “Raft” locking plate and fixation using lateral "T" shaped plate for complex Tibial Plateau Fracture (TPF) involving posteromedial column. Twenty-eight corpses were selected. The upper and the lower ends of the tibia of the femur were taken as the bone specimens. Totally 28 models of complex TPF involving posteromedial column were made according to Kelly method. All models were randomly divided into group A (14 models) and group B (14 models). Group A was performed with the fixation using supporting board at inner side and “Raft” locking plate at outer side. Group B was performed with fixation using lateral "T" shaped plate. The changes of torque, stiffness of horizontal shear, axial stiffness and load displacement of two groups were examined and compared, and the biomechanical characteristics of two groups were discussed. Results showed that, the average load of displacement in group A was 0.07 ± 0.01 mm, which was significantly lower than 0.12 ± 0.03 mm in group B (P<0.05). The average axial stiffness in group A was 3157 ± 346 N/mm, which was significantly higher than 2683 ± 253 N/mm in group B (P<0.05). The average stiffness of horizontal shear in group A was 2165 ± 217 N•m•Deg^-1, which was significantly higher than 1593 ± 142 N•m•Deg^-1 in group B (P<0.05). The average torque changes in group A was 1.93 ± 0.21 N•m, which was significantly higher than 1.52 ± 0.14 N•m in group B (P<0.05). Compared with fixation using lateral "T" shaped plate, the internal fixation using inner-side supporting board plus “Raft” locking plate can obtain better biomechanical stability for treatment of complex TPF involving posteromedial column.