Characteristics of proximal tibial epiphysis structure and effectiveness of impression fragments fixation in tibial 57 condylar fractures (in vitro study)

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The structure of cancellous bone of the proximal tibial epiphysis using CT and measurement of Leeb hardness was investigated. The author found that subchondral layer as thick as 10 - 15 mm which corresponds with the thickness of impressed fragments of tibial condylar fracture has the density and elasticity modulus up to 84,4% of lowest threshold value of the compact bone. In more deep layers from cartilage the cancellous bone progressively loose it’s density and hardness and deeper than 40 mm they reach their lowest threshold value. Higher level of plating with screwing through impression fragment can persist significantly more (p<0,05) cyclic loading (24066±2015) even without bone grafting, than the same fixators inserted lower with deeper than 20 mm screwing through the bone graft (2133±446 cyclic loading). Such application of the plate with passing screws through subchondral layer of impression fragments at the level of 5-7 mm from joint cartilage can be achieved by anatomic preoperational pre-bending of any fixator.

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I. Voronkevich

Vreden Russian Research Institute of Traumatology and Orthopedics

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Email: dr.voronkevich@inbox.ru
俄罗斯联邦

参考

  1. Ключевский В.В. Хирургия повреждений: руководство для хирургов и травматологов районных больниц. Рыбинск: Рыбинский дом печати; 2004. 784 с
  2. Кузнецов, И.А. Оперативное лечение компрессионно-оскольчатых переломов мыщелков большеберцовой кости. В кн.: Внутренний остеосинтез, проблемы и перспективы развития: тез. докл. науч.-практ. конф. СПб.; 1995. с. 34-36
  3. Ali A.M., El-Shafie M., Willett K.M. Failure of fixation of tibia plateau fractures. J. Orthop. Trauma. 2002;16(5):323-329.
  4. Beris A.E., Soucacos P.N., Glisson R.R., Seaber A.V., Urbaniak J.R. Load tolerance of tibial plateau depressions reinforced with a cluster of K-wires. Bull. Hosp. Jt. Dis. 1996;55(1):12-15.
  5. Finlay J.B., Bourne R.B., Kraemer W.J., Moroz T.K., Rorabeck C.H. Stiffness of bone underlying the tibial plateaus of osteoarthritic and normal knees. Clin. Orthop. Relat. Res. 1989;(247):193-201.
  6. Goldstein S.A., Wilson D.L., Sonstegard D.A., Matthews L.S. The mechanical properties of human tibial trabecular bone as a function of metaphyseal location. J. Biomech. 1983;16(12):965 — 969.
  7. Gösling T., Schandelmaier P., Marti A., Hufner T., Partenheimer A., Krettek C. Less invasive stabilization of complex tibial plateau fractures: a biomechanical evaluation of a unilateral locked screw plate and double plating. J. Orthop. Trauma. 2004;18(8):546-551.
  8. Goulet R.W., Goldstein S.A., Ciarelli M.J., Kuhn J.L., Brown M.B., Feldkamp L.A. T relationship between the structural and orthogonal compressive properties trabecular bone. J. Biomech. 1994;27(4):375-389.
  9. Jiang R., Luo C.F., Zeng B.F. Biomechanical evaluation of different fixation methods for fracture dislocation involving the proximal tibia. Clin. Biomech. (Bristol). 2008;23(8):1059-106.
  10. Kamibayashi L., Wyss U.P., Cooke T.D., Zee B. Trabecular microstructure in the medial condyle of the proximal tibia of patients with knee osteoarthritis. Bone. 1995;17(1):27-35.
  11. Kowalski M.J., Schemitsch E.H., Harrington R.M., Chapman J.R., Swiontkowski M.F. A comparative biomechanical evaluation of a noncontacting plate and currently used devices for tibial fixation. J. Trauma. 1996;40(1):5-9.
  12. Lachiewicz P.F., Funcik T. Factors influencing the results of open reduction and internal fixation of tibial plateau fractures. Clin. Orthop. Relat. Res. 1990;259:210-215.
  13. McRae R., Esser M. Practical fracture treatment. 5th ed. Edinburg etc: Churchill Livingstone; 2008. 447 p.
  14. Schatzker J., McBroom R., Bruce D. The tibial plateau fracture. The Toronto experience 1968—1975. Clin. Orthop. Relat. Res. 1979;138:94-104.
  15. Thomas C., Athanasiov A., Wullschleger M., Schuetz M. Current concepts in tibial plateau fractures. Acta Chir. Orthop. Traumatol. Cech. 2009;76(5):363-373.

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