Original ArticleSplit-Depressed Lateral Tibial Plateau Fractures: A Comparison of Augmented Percutaneous Screws Versus Augmented Plate and Screw Construct in a Cadaveric ModelBowles, Richard J. MD*; Chadayammuri, Vivek MD*; Baldini, Todd MSc*; Brecevich, Antonio MD†; Mauffrey, Cyril MD, FACS, FRCS‡Author Information *Department of Orthopaedic Surgery, University of Colorado School of Medicine, Aurora, CO; †Department of Orthopaedic Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; and ‡Department of Orthopaedic Surgery, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO. Reprints: Cyril Mauffrey, MD, FACS, FRCS, Department of Orthopaedic Surgery, Denver Health Medical Center, University of Colorado School of Medicine, 777 Bannock St, Denver, CO 80204 (e-mail: [email protected]). R. J. Bowles received a grant from the University of Colorado School of Medicine in support of this work. T. Baldini has received financial support from SMV Scientific and Stryker Endoscopy, outside of the presented work. C. Mauffrey is an unpaid consultant for Stryker and has received an honorarium and/or research funding from the AO Foundation, Abbott Medical, Carbolic Orthopedics, and Dupuy-Synthes. The remaining authors report no conflict of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jorthotrauma.com). Journal of Orthopaedic Trauma: July 2018 - Volume 32 - Issue 7 - p e270-e275 doi: 10.1097/BOT.0000000000001177 Buy SDC Metrics Abstract Objectives: To compare the strength of fixation of percutaneous screw versus plate/screw fixation in a paired cadaver model of OTA 41-B3 (Schatzker type II) split-depression fractures of the lateral tibial plateau. Methods: Six matched pairs of cadaveric knees were acquired. An OTA 41-B3 (Schatzker type II) split-depression fracture was created in all specimens using a standardized method. One specimen from each matched pair of knees was fixed with percutaneous screws, and the other was fixed with a plate/screw construct. All specimens underwent augmentation of the central metaphyseal defect with calcium phosphate. Mean residual displacement (depression) was measured on thin-slice high-resolution computed tomography using a standardized methodology following 3 experimental conditions: (1) after they were fixed, before loading; (2) unloaded cycling (simulating postoperative range of motion exercises); and (3) loaded cycling (simulating postoperative weight-bearing). Load to failure was also compared. Results: After adjustment for baseline measurements, there was no significant difference in mean residual depression of the lateral tibial plateau between treatments groups after unloaded or loaded cyclic testing. Mean residual depression was less than 1 mm in both the treatment groups. Load to failure was statistically equivalent between treatment groups. Conclusions: In our cadaveric study, in combination with calcium phosphate augmentation for both methods, percutaneous screw fixation conferred comparable strength of fixation compared with plate/screw constructs for treatment of OTA 41-B3 (Schatzker type II) tibial plateau fractures. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.