Minimally invasive reconstruction of lateral tibial plateau fractures using the jail technique: a biomechanical study

BMC Musculoskeletal Disorders

Michael J Raschke¹  Wolf Petersen²  Benedikt Schliemann¹  Mirco Herbort¹  Thomas Heinkele¹  Andre Weimann¹ 

[1]Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Münster, Münster, Germany

[2]Department of Traumasurgery, Martin-Luther-Hospital, Berlin, Germany

关键词: Failure;    Stiffness;    Load;    Displacement;    Osteosynthesis;    Jail technique;    Tibial plateau fractures;   

Others  :  1132998
DOI  :  10.1186/1471-2474-14-120

 received in 2012-07-16, accepted in 2013-03-26,  发布年份 2013

【 摘 要 】

Background

This study described a novel, minimally invasive reconstruction technique of lateral tibial plateau fractures using a three-screw jail technique and compared it to a conventional two-screw osteosynthesis technique. The benefit of an additional screw implanted in the proximal tibia from the anterior at an angle of 90° below the conventional two-screw reconstruction after lateral tibial plateau fracture was evaluated. This new method was called the jail technique.

Methods

The two reconstruction techniques were tested using a porcine model (n = 40). Fracture was simulated using a defined osteotomy of the lateral tibial plateau. Load-to-failure and multiple cyclic loading tests were conducted using a material testing machine. Twenty tibias were used for each reconstruction technique, ten of which were loaded in a load-to-failure protocol and ten cyclically loaded (5000 times) between 200 and 1000 N using a ramp protocol. Displacement, stiffness and yield load were determined from the resulting load displacement curve. Failure was macroscopically documented.

Results

In the load-to-failure testing, the jail technique showed a significantly higher mean maximum load (2275.9 N) in comparison to the conventional reconstruction (1796.5 N, p < 0.001). The trend for better outcomes for the novel technique in terms of stiffness and yield load did not reach statistical significance (p > 0.05). In cyclic testing, the jail technique also showed better trends in displacement that were not statistically significant. Failure modes showed a tendency of screws cutting through the bone (cut-out) in the conventional reconstruction. No cut-out but a bending of the lag screws at the site of the additional third screw was observed in the jail technique.

Conclusions

The results of this study indicate that the jail and the conventional technique have seemingly similar biomechanical properties. This suggests that the jail technique may be a feasible alternative to conventional screw osteosynthesis in the minimally invasive reconstruction of lateral tibial plateau fractures. A potential advantage of the jail technique is the prevention of screw cut-outs through the cancellous bone.

【 授权许可】

   
2013 Weimann et al.; licensee BioMed Central Ltd.

【 图 表 】

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