|Publisher DOI:||10.1007/s00068-020-01538-3||Title:||Biomechanical aspects of the posteromedial split in bicondylar tibial plateau fractures—a finite-element investigation||Language:||German||Authors:||Dehoust, Julius
|Keywords:||Bicondylar tibial plateau fracture; Biomechanics; Finite-element method; Fixation; Posteromedial split||Issue Date:||Nov-2020||Source:||European Journal of Trauma and Emergency Surgery 46: 1257–1266 (2020-11)||Abstract (english):||
Purpose: To gain principal insight into fixation techniques of a posteromedial split fragment in bicondylar tibial plateau fractures. Methods: A computer simulation was performed, applying the finite-element method (FEM) to compare four methods of fixation of the posteromedial split fragment: lateral plate (model 1), lateral plate and kickstand screw (model 2), lateral plate and two antero-posterior lag screws (model 3), and lateral and posteromedial plate (model 4). The displacement of the fragment and material stresses in implants and bone under 2500 N axial load were analyzed. Results: Maximal displacement of the posteromedial split fragment of 2.8 mm was found with a sole lateral plate. An added kickstand screw decreased the displacement to 1.46 mm. Added lag screws improved stability by a factor 4, with a maximal displacement of 0.76 mm. The double-plate configuration revealed 0.27 mm, a decrease of the displacement by a factor 10 compared to model 1. An additional analysis of posteromedial fragment displacements with osteoporotic bone, simulated by dividing the elastic modulus of the bone by a factor 2, turned out to be of relevant impact. For model 1, the calculations did not converge. The influence of bone quality was found to be 70% in model 2, 60% in model 3, and 40% in model 4. Conclusions: The results indicate that the additional fixation of a posteromedial split fracture by plate osteosynthesis might be advantageous in bicondylar tibial plateau fractures treated with lateral plating. This might be even more important in patients with low bone quality.
|URI:||http://hdl.handle.net/11420/7898||ISSN:||1863-9933||Journal:||European journal of trauma and emergency surgery||Institute:||Integrierte Schaltungen E-9||Document Type:||Article|
|Appears in Collections:||Publications without fulltext|
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