Comparison of three fixations for tibial plateau fractures by biomechanical study and radiographic observation

Abstract

Aim: The aim of this study was to compare the fixation effects of three fixation devices for tibial plateau fracture (AO/OTA classification 41 A1).

Methods: Sixteen human cadaver tibial specimens were randomly divided into four groups. An A1 fracture model was established. The fractures were subsequently fixed by axial controlled intramedullary nail, external fixation and steel plate fixation. Each specimen was subjected to axial compression, torsion test and three-point bending test. Then a rat model was used to evaluate the therapeutic effect of these three fixations by evaluation of callus formation time and healing time.

Results: It was found that the axial controlled intramedullary nail group obtained superior biomechanical properties of resistance ability of bending, torsional and axial compressive, compared with external fixation and steel plate group. In animal experiments, the axial controlled intramedullary nail group had a significant shorter callus occurrence and healing time than steel plate and external fixator group.

Conclusion: The axial controlled intramedullary nail fixation has a superior biomechanical characteristic and fixation effect for tibial plateau fractures than steel plate and external fixator.

Keywords: Axial controlled intramedullary nail; External fixation; Steel plate fixation.