Biomechanical comparison of plate-screw and screw fixation in medial tibial plateau fractures (Schatzker IV). A model study [étude comparative biomécanique de l'ostéosynthèse par plaque vissée versus vis dans les fractures du plateau tibial médial de type Schatzker 4]

摘要

Introduction: The objective of this biomechanical study was to compare the respective efficiency of plate-screw fixation and screw fixation in an experimental model of a Schatzker type IV fracture. Hypothesis: Screw fixation and plate fixation have a similar load to failure. Materials and methods: This study compares the stability of Schatzker type IV medial tibial plateau fractures fixed with either three 6.5. mm cancellous bone screws with a 16. mm threaded segment or with six-holed buttress T plate-screw system. A Schatzker type IV fracture was modeled on an artificial bone model. In a first group of 10 fracture models, following the anatomical reduction, fractures were stabilized with screws with washers. In the second group of 10 fracture models, fractures were stabilized with T plate. After fixation, ascending axial compression was applied on bone models (Instron machine). Results: Load bearing capacity was 1397.6 ± 194.4 in group I and 2153.2 ± 204.4 in group II. The difference between two groups were statistically significant (p<0.001). Discussion: According to this result, experimental load bearing of bone models indicates that plate-screw fixation system has a significantly higher stabilization capacity than fixation with three screws alone. Our hypothesis was not confirmed. In order to maintain anatomical repositioning, the plate-screw system is a more stable fixation method than the screw in medial tibial plateau fractures of Schatzker type IV.