[Biomechanical comparison of two different wire stretching methods in the treatment of tibial plateau fractures with the Ilizarov echnique and the related clinical results].

Objectives: In this study, the divergent wire stretching method used to fix the fractured pieces in the Ilizarov technique is biomechanically compared with the olive wire fixation method.

Patients And Methods: Between 1999 and 2005, 36 tibial plateau fractures of 34 patients (27 males, 7 females; mean age 48.4; range 26 to 81 years) were treated with the Ilizarov technique. Divergent wire stretching technique was used in all cases. Patients were mobilized regardless of fracture type and with full load bearing in the shortest possible time after the operation. In the second stage of this study, in order to achieve interfragmentary compression, the reciprocal olive wire method was compared with the divergent wire stretching method developed by us on tibia models at the biomechanic laboratory.

Results: All cases were mobilized with full weight bearing at the early postoperative period. The fusion period was 14 weeks and fixators were removed at an average of 19 weeks. No deep infection was observed in any of the cases. No other surgical intervention was required for nonunion or reduction failure. More than 2 mm separation was detected in 12 cases during 24 weeks of observation. But this has not been considered to be clinically significant. In 29 cases, the knee range of motion was 0-135 degrees. In the biomechanical phase of the study, no distinct difference was observed between the classic olive wire stretching method and the divergent wire stretching method regarding the preservation of the interfragmentary compression under weight. The divergent wire stretching method was significantly superior in achieving an homogeneous interfragmentary compression.

Conclusion: The divergent wire stretching technique applied parallel to the Ilizarov fixation technique is an effective method for the early and unrestricted mobilization of the patients and the preservation of the range-of-motion of the joint.