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

Revista do Colégio Brasileiro de Cirurgiões
Vincenzo GiordanoHilton A Koch

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 pres...Continue Reading

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