Medial buttress versus lateral locked plating in a cadaver medial tibial plateau fracture model.

Abstract

To compare the mechanical stability of a medial tibial plateau fracture model secured with a lateral locking periarticular plate versus a medial buttress plate in cyclic testing and load to failure. Medial tibial plateau fractures were created in 6 matched pairs of fresh cadaveric tibias. In each pair of tibias, 1 side was randomly selected to be fixed with a lateral locking plate on 1 side and the contralateral limb to be fixed with a medial buttress plate. The fixated tibias then underwent cyclic testing followed by single-cycle failure compressive loading. Displacement of the medial tibial plateau was measured in both cyclic and failure testing. Statistical analyses revealed relevant trends in fixation strength during cyclic testing, but neither the mean maximum displacement during nor mean residual displacement after cyclic testing were statistically different between the 2 fixation techniques. Statistically significant differences were observed for the mean forces to failure however. The medial buttress plate construct provided greater fixation strength with its failure force of 4136 +/- 1469 N compared with the lateral locking plate mean failure force of 2895 +/- 1237 N (P < 0.05). In the setting of a vertically oriented fracture in a medial tibial plateau without comminution, the medial buttress plate provides significantly greater stability in static loading, and a trend toward improved stability with cyclic loading. Clinical correlation is necessary to substantiate these findings.