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Biomechanical Study of the Elastic Fixation of the Posterolateral Fracture of the Tibial Plateau: Arrow Technique

Biomechanical Study of the Elastic Fixation of the Posterolateral Fracture of the Tibial Plateau: Arrow Technique

Oscar Ares, PhD, SPAIN David Gutierrez Medina, MD, SPAIN Carlos Andres Morales-Marin, MD, SPAIN Salvador Madariaga, MD, SPAIN Andrea Sallent, MD, PhD, SPAIN Jose Alonso Zumbado, MD, SPAIN Manuel Llusà, SPAIN

Hospital Clinic de Barcelona, Barcelona, Barcelona, SPAIN

2023 Congress   ePoster Presentation   2023 Congress   Not yet rated


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Summary: New minimally invasive technique for posterolateral fractures associated with ACL rupture

The incidence of lateral plate fractures diagnosis in anterior cruciate ligament injuries can reach up to 50% depending on the series. The associated bone injury can range from bone edema to a depressed fracture or a displaced fracture.
We present a new technique for the synthesis of split fractures.
We conducted a study that included 16 proximal tibiae. Using an oscillating saw, a coronal osteotomy was performed 1 cm from the lateral end of the tibia, mimicking a Bernholt type 3A external tibial plateau fracture. Subsequently, we randomized them into two groups, group A fixation using a suspension system and group B fixation with a 3.5 cortical screw from posterior to anterior. Subsequently, we performed a compression force until the fracture displacement with Mecmesin MultiTest 2.5-d and Advanced Force Gauge (AFG) 1000N).
A force-displacement curve was made for each piece and the area under the curve was measured with an "update-mean" technique to assess the resistance of the fixing systems and the force necessary to obtain a certain displacement.
The results show that the compression screw technique and the suspension technique support the same loads without statistically significant differences.

Our study demonstrates that the arrow technique using suspension fixation appears to be as stable as compression screw fixation in the human specimens tested. However, additional benefits of using the suspension technique, such as an easier surgery technique, should be aknowledged to avoid surgeries that compromise the posterolateral part the knee.

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