A Biomechanical Comparison Study of Plate-Nail and Dual-Plate Fixation in AO/OTA 41-C2 Tibial Plateau Fractures.

Background Context: This study's purpose was to evaluate the biomechanical performance of plate-nail and dual-plate fixation for the treatment of AO/OTA 41-C2 tibial plateau fractures.

Methods: Twenty synthetic tibias were selected and randomly divided into a plate-nail group ( = 10) and a dual-plate group ( = 10). After the artificial tibias were osteotomized to simulate AO/OTA 41-C2 tibial plateau fractures in both groups, the plate-nail and the dual-plate methods, respectively, were used for fixation, and then axial compression loading, three-point bending, torsion, and axial failure tests were carried out. The data of each group were recorded and statistically analyzed.

Results: In the axial compression test, the average stiffness of the plate-nail group was higher than that of the dual-plate group ( < 0.05). The displacement generated in the plate-nail group was significantly smaller than that in the dual-plate group ( < 0.05). In the resisting varus test, the stress of the plate-nail group was significantly higher than that of the dual-plate group ( < 0.05). In the resisting valgus test, the stress of the plate-nail group was slightly higher than that of the dual-plate group, but the difference was not statistically significant ( > 0.05). In the static torsion test, the load applied to the plate-nail group was smaller than that of the dual-plate group when rotated to 5° ( < 0.05). In the axial compression failure test, the average ultimate load of the plate-nail group was significantly higher than that of the dual-plate group ( < 0.05).

Conclusion: The treatment of AO/OTA 41-C2 tibial plateau fractures with plate-nail fixation is superior to that with dual-plate fixation in resisting axial stress and preventing tibial varus deformity, while dual-plate fixation has better resisting torsional ability.