Objective: To compare the mechanical stability of a medial tibial plateau fracture model secured with a lateral locking periarticular plate versus a medial buttress plate in cyclic testing and load to failure.
Methods: Medial tibial plateau fractures were created in 6 matched pairs of fresh cadaveric tibias. In each pair of tibias, 1 side was randomly selected to be fixed with a lateral locking plate on 1 side and the contralateral limb to be fixed with a medial buttress plate. The fixated tibias then underwent cyclic testing followed by single-cycle failure compressive loading. Displacement of the medial tibial plateau was measured in both cyclic and failure testing.
Results: Statistical analyses revealed relevant trends in fixation strength during cyclic testing, but neither the mean maximum displacement during nor mean residual displacement after cyclic testing were statistically different between the 2 fixation techniques. Statistically significant differences were observed for the mean forces to failure however. The medial buttress plate construct provided greater fixation strength with its failure force of 4136 ± 1469 N compared with the lateral locking plate mean failure force of 2895 ± 1237 N (P < 0.05).
Conclusion: In the setting of a vertically oriented fracture in a medial tibial plateau without comminution, the medial buttress plate provides significantly greater stability in static loading, and a trend toward improved stability with cyclic loading. Clinical correlation is necessary to substantiate these findings.