Chen Pengbo, Lu Hua, Shen Hao, Wang Wei, Ni Binbin, Chen Jishizhan
Department of Orthopedics, Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine, No. 1665 Kongjiang Road Yangpu District, Shanghai, 200092, China.
J Orthop Surg Res. 2017 Feb 23;12(1):35. doi: 10.1186/s13018-017-0531-1.
Lateral column tibial plateau fracture fixation with a locking screw plate has higher mechanical stability than other fixation methods. The objectives of the present study were to introduce two newly designed locking anatomic plates for lateral tibial plateau fracture and to demonstrate their characteristics of the fixation complexes under the axial loads.
Three different 3D finite element models of the lateral tibial plateau fracture with the bone plates were created. Various axial forces (100, 500, 1000, and 1500 N) were applied to simulate the axial compressive load on an adult knee during daily life. The equivalent maps of displacement and stress were output, and relative displacement was calculated along the fracture lines.
The displacement and stresses in the fixation complexes increased with the axial force. The equivalent displacement or stress map of each fixation under different axial forces showed similar distributing characteristics. The motion characteristics of the three models differed, and the max-shear stress of trabecula increased with the axial load.
These two novel plates could fix lateral tibial plateau fractures involving anterolateral and posterolateral fragments. Motions after open reduction and stable internal fixation should be advised to decrease the risk of trabecular microfracture. The relative displacement of the posterolateral fragments is different when using anterolateral plate and posterolateral plate, which should be considered in choosing the implants for different posterolateral plateau fractures.
使用锁定螺钉钢板固定胫骨外侧平台骨折,其机械稳定性高于其他固定方法。本研究的目的是介绍两种新设计的用于胫骨外侧平台骨折的锁定解剖钢板,并展示它们在轴向载荷下固定复合体的特性。
创建了三种不同的带有骨板的胫骨外侧平台骨折三维有限元模型。施加各种轴向力(100、500、1000和1500 N)以模拟成年人日常生活中膝关节上的轴向压缩载荷。输出位移和应力的等效图,并计算沿骨折线的相对位移。
固定复合体中的位移和应力随轴向力增加。不同轴向力下每种固定的等效位移或应力图显示出相似的分布特征。三种模型的运动特征不同,小梁的最大剪应力随轴向载荷增加。
这两种新型钢板可固定涉及前外侧和后外侧骨折块的胫骨外侧平台骨折。建议切开复位并稳定内固定后进行活动,以降低小梁微骨折的风险。使用前外侧钢板和后外侧钢板时,后外侧骨折块的相对位移不同,在为不同的后外侧平台骨折选择植入物时应予以考虑。