Biomechanical Comparison And Clinical Analysis Of Three Different Fixation Methods For Postermedial Tibial Plateau Fracture

Objective To compare and analysis the biomechanical performance of three different fixation methods for postermedial tibial plateau fracture. We Analysis and compare the effect of using four methods of treatment to postermedial tibial plateau fracture,in order to select the best clinical pathwayMethods Twenty fresh tibitial specimens were made into models of oblique fracture.Five models were fixed with dual reconstruction plate,and five models were fixed with T shaped plate ,and five models were fixed with hollow screws .Each model was tested for its biomechanical performance (strain,displacement,stress intensity,stiffness and rotary performance)。Fifty cases of postermedial tibial plateau fracture were treated,Five models were fixed with dual reconstruction plate,and five models were fixed with T shaped plate ,and five models were fixed with hollow screws. We observe fracture healing by X-ray films per month ,Assess functional recovery According to Rasmussen marking and statistical analysis .Rsults: The model of dual reconstruction plate : strain-displacement(0.08±0.01),stress intensity(3226±258),stiffness(1654±148),rotary performance(1.58±0.14);the model of T shaped plate: strain-displacement ( 0.11±0.03 ),stress intensity(2778±247),stiffness(1654±148),rotary performance(1.58±0.14); The model of hollow screws: strain-displacement(0.13±0.02),stress intensity(2632±223),stiffness(1400±120),rotary performance(1.49±0.15). The performance of dual reconstruction plate was superior than that of T shaped plate and hollow screws with limited internal fixation in strain-displacement,stress,intensity stiffness and rotary performance(p<0.05). Rasmussen scores: A group : excellent in 1 cases, better in 2 case, good in 1 cases and failed in 1 cases .B group: excellent in 2 cases, better in 1 cases, good in 2 cases, 0 case of failure .C group:were excellent in 3 cases, better in 1 cases. good in 1 cases, 0 case of failure .C group healing rate and function scores were significantly higher than the A group, B group(P <0.05).Conclusion The double-plate fixation method can achieve a stronger fixation and minimaller stress-shielding ,fewer trauma and complications, higher fracture healing rate and functional recovery than the other two kinds of methods , so it is recommended.