| Abstract: | BACKGROUND: Due to the special anatomical location of posterolateral column fracture of tibial plateau, there is no consensus on the choice of surgical approach and internal fixation. OBJECTIVE: To compare the biomechanical stability of novel plate and three common internal fixators in the fixation of posterolateral column fracture of tibial plateau by finite element analysis, and verify the feasibility of novel plate. METHODS: The CT data of a volunteer were collected and the new type of plate was designed and imported into SolidWorks software to establish a fracture model of the posterolateral column fracture of the tibial plateau. Four internal fixation models (novel plate, L-shaped locking plate, oblique T-shaped plate, and lag screw) were established, with axial loads of 500, 1 000 and 1 500 N. The maximum displacement of fracture block and stress distribution and peak value of internal fixator were compared among different internal fixation models. RESULTS AND CONCLUSION: With the increase of axial force, the displacement of fracture block and the peak stress of internal fixation in different internal fixation models increased approximately in equal ratio. The displacement nephogram and the stress nephogram showed similar distribution characteristics. (1) Under three loads, fracture block displacement from high to low was as follows: lag screw group > L-shaped locking plate group > novel plate group > oblique T-shaped plate group. The maximum displacement of the fracture block in the novel plate group, the L-shaped locking plate group and the lag screw group was located at the proximal end of the lateral border, and the displacement gradually decreased from the proximal end to the distal end. The maximum displacement of the fracture block in the oblique T-shaped plate group was located in the middle of the lateral border, and the displacement gradually decreased from the outside to the inside. (2) Under three loads, stress peak value of internal fixation from high to low was as follows: oblique T-shaped plate group > novel plate group > lag screw group > L-shaped locking plate group. (3) Stress distribution of internal fixation of novel plate group and oblique T-shaped plate group was relatively uniform. In lag screw group, obvious stress concentration could be seen in the middle of medial screws. The stress distribution of L-shaped locking plate group was the most uniform. (4) The results showed that the stress distribution of the internal fixtures in the L-shaped locking plate group was the most uniform and minimal, but the fracture block displacement was large and similar to that of the lag screw group. Therefore, the biomechanical stability of the novel plate was better than that of L-shaped locking plate and lag screw, with a good application foundation. © 2023, Publishing House of Chinese Journal of Tissue Engineering Research. All rights reserved. |
