Plate-screw and screw-washer stability in a Schatzker type-I lateral tibial plateau fracture: a comparative biomechanical study

Abstract

<jats:p>ABSTRACT The aim of this study was to evaluate the biomechanical role of both a non-locking two-hole small fragment dynamic compression plate with 3.5-mm screws and a 4.5-mm cortical screw with a washer applied to a Schatzker type-I tibial plateau fracture. Sixteen right synthetic tibiae were used to create an anterolateral shear tibial plateau fracture (Schatzker type-I fracture). Eight models were fixed with a small fragment non-locked straight dynamic compression plate with one 3.5-mm bicortical screw (plate-screw construction) and eight models were fixed with a 4.5-mm cortical screw and a washer (screw-washer construction), both inserted at 1.0 mm distal to the apex of the fracture. Specimens were tested up to the onset of yielding at a constant strain rate of 5.0-mm/min. Stiffness ranged from 311.83 N/mm to 199.54 N/mm, with a mean + SD of 260.32 + 33.8 N/mm in the plate-screw construction, and from 290.34 N/mm to 99.16 N/mm, with a mean + SD of 220.46 + 63.12 N/mm in screw-washer construction. There was no significant difference (p=0.172). Use of a two-hole small-fragment non-locked plate with one 3.5-mm cortical screw or a 4.5-mm cortical screw with a washer applied at 1.0 mm distal to the apex of the fracture as buttressing present similar stiffness in terms of preventing axial displacement in synthetic tibiae models tested up to the onset of yielding.</jats:p>

Clinical efficacy and safety of surgery combined with 3D printing for tibial plateau fractures: systematic review and meta-analysis

“…3D printing-assisted Schatzker IV-VI tibial platform fracture has the advantages of reduced surgical time, perspective times, bleeding volume, and complications, and better postoperative functional recovery of patients, which is worthy of clinical application and promotion (33)(34)(35). More large clinical RCTs and relevant biomechanical research are needed for theoretical and clinical demonstration.…”

Application of 3D modeling in a personalized approach to bone osteosynthesis (A literature review)

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