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Archives of Orthopaedic and Trauma Surgery

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Open Access 01-11-2020 | Tibial Plateau Fracture | Trauma Surgery

The effect of coronal splits on the structural stability of bi-condylar tibial plateau fractures: a biomechanical investigation

Authors: Shabnam Samsami, Robert Pätzold, Martin Winkler, Sven Herrmann, Peter Augat

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 11/2020

Abstract

Introduction

Surgical treatment of bi-condylar tibial plateau fractures is still challenging due to the complexity of the fracture and the difficult surgical approach. Coronal fracture lines are associated with a high risk of fixation failure. However, previous biomechanical studies and fracture classifications have disregarded coronal fracture lines.

Materials and methods

This study aimed to develop a clinically relevant fracture model (Fracture C) and compare its mechanical behavior with the traditional Horwitz model (Fracture H). Twelve samples of fourth-generation tibia Sawbones were utilized to realize two fracture models with (Fracture C) or without (Fracture H) a coronal fracture line and both fixed with lateral locking plates. Loading of the tibial plateau was introduced through artificial femur condyles to cyclically load the fracture constructs until failure. Stiffness, fracture gap movements, failure loads as well as relative displacements and rotations of fracture fragments were measured.

Results

The presence of a coronal fracture line reduced fracture construct stiffness by 43% (p = 0.013) and decreased the failure load by 38% from 593 ± 159 to 368 ± 63 N (p = 0.016). Largest displacements were observed at the medial aspect between the tibial plateau and the tibial shaft in the longitudinal direction. Again, the presence of the coronal fracture line reduced the stability of the fragments and created increased joint incongruities.

Conclusions

Coronal articular fracture lines substantially affect the mechanical response of tibia implant structures specifically on the medial side. With this in mind, utilizing a clinically relevant fracture model for biomechanical evaluations regarding bi-condylar tibial plateau fractures is strongly recommended.

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Title: The effect of coronal splits on the structural stability of bi-condylar tibial plateau fractures: a biomechanical investigation
Authors: Shabnam Samsami
Robert Pätzold
Martin Winkler
Sven Herrmann
Peter Augat
Publication date: 01-11-2020
Publisher: Springer Berlin Heidelberg
Keyword: Tibial Plateau Fracture
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 11/2020
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-020-03412-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The effect of coronal splits on the structural stability of bi-condylar tibial plateau fractures: a biomechanical investigation

Abstract

Introduction

Materials and methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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