Distal tibia extra-articular fractures can be difficult to treat Tenuous soft tissue Complex fracture patterns Plate Fixation Options Medial plating: Minimally invasive approach Technical ease Anterolateral plating Robust soft tissue coverage Better fracture visualization Fracture pattern should be considered when deciding between plate applications Objective: Compare biomechanical properties of both plate options to stabilize varus and valgus fractures
16 4 th generation tibia bone models with simulated oblique OTA 43-A1.2 distal tibia fractures Valgus Pattern Model 45 osteotomy proximal/lateral to distal/medial Varus Pattern Model 45 osteotomy proximal/medial to distal/lateral
Osteotomies plated using a medial or anterolateral distal tibial locking plate Specimens potted into a custom jig in polymethylmethacrylate cement Loading Protocol - Compressive Stiffness Body weight (standing) - Torsional Stiffness Internal / External Rotation - Cyclic Loading 2 x body weight (walking) - Load to Failure Statistical analysis was performed using Mann Whitney U tests.
Varus Fracture Pattern Medial plating stiffer in both compression and torsion Valgus Fracture Pattern No difference between medial and anterolateral plating
Medial plates had superior biomechanical performance compared to anterolateral plates when used to stabilize varus fracture patterns. In this application they functioned in anti-glide mode. For valgus fracture patterns, no biomechanical differences between anterolateral and medial plating were observed. In clinical practice, surgeons should take this biomechanical evidence into account and perform a plating that optimizes stability.
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