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

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.

Titel: Minimally invasive reconstruction of lateral tibial plateau fractures using the jail technique: a biomechanical study
Verfasser: Weimann, Andre
Heinkele, Thomas
Herbort, Mirco GND
Schliemann, Benedikt GND
Petersen, Wolf
Raschke, Michael J.
Organisation: FB 05: Medizinische Fakultät
Dokumenttyp: Artikel
Medientyp: Text
Erscheinungsdatum: 04.04.2013
Publikation in MIAMI: 21.02.2014
Datum der letzten Änderung: 16.04.2019
Quelle: BMC Musculoskeletal Disorders 14 (2013) 120
Schlagwörter: Tibial plateau fractures; Jail technique; Osteosynthesis; Displacement; Load; Stiffness; Failure
Fachgebiete: Medizin und Gesundheit
Lizenz: CC BY 2.0
Sprache: Englisch
Anmerkungen: Finanziert durch den Open-Access-Publikationsfonds 2013/2014 der Deutschen Forschungsgemeinschaft (DFG) und der Westfälischen Wilhelms-Universität Münster (WWU Münster).
Format: PDF-Dokument
URN: urn:nbn:de:hbz:6-24319673468
DOI: 10.1186/1471-2474-14-120