BMC musculoskeletal disorders · 2026
Biomechanical comparison of a novel hockey-stick locking plate with a pes anserinus sparing design for Schatzker IV tibial plateau fractures.
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Wang Xiao, Dong Li, Wako Gadisa Musa, Yan Junwei, Liang Bin
Аннотация
BACKGROUND: Stable fixation of Schatzker IV tibial plateau fractures is crucial for functional recovery. Conventional plating techniques can compromise the pes anserinus tendon. This study biomechanically evaluates a novel hockey-stick locking plate (NHLP), which features a pes anserinus sparing design, against a traditional T-shaped locking plate (TTLP) and a double reconstruction locking plate (DRLP).
METHODS: Eighteen synthetic tibiae (Sawbones) with a standardized Schatzker IV fracture model were randomly assigned to three fixation groups (NHLP, TTLP, DRLP; n = 6/group). All constructs underwent quasi-static compression, cyclic loading, and load to failure testing. Construct stiffness, interval and cumulative displacement, changes in fracture gap and articular step-off, and ultimate failure load were measured.
RESULTS: The NHLP construct demonstrated significantly lower stiffness and a lower ultimate failure load compared to the TTLP and DRLP. During cyclic loading, no significant differences were observed in interval displacement among the groups; however, the cumulative displacement of the NHLP group was significantly greater than the other two (P < 0.001). All three constructs effectively maintained the articular surface, with no significant differences in fracture gap or anterior/central step-off. For posterior articular step-off, the NHLP provided superior control compared to the TTLP (P < 0.001) and was comparable to the DRLP.
CONCLUSION: In this biomechanical study of a Schatzker IV fracture model, the NHLP demonstrated lower overall stiffness and strength than conventional plates but provided superior stabilization of the posterior articular surface. The construct's ultimate strength was found to be sufficient for expected early postoperative physiological loads. The NHLP represents a biomechanically viable option for this fracture pattern, particularly given its design feature of sparing the pes anserinus.
CLINICAL TRIAL NUMBER: Not applicable.
METHODS: Eighteen synthetic tibiae (Sawbones) with a standardized Schatzker IV fracture model were randomly assigned to three fixation groups (NHLP, TTLP, DRLP; n = 6/group). All constructs underwent quasi-static compression, cyclic loading, and load to failure testing. Construct stiffness, interval and cumulative displacement, changes in fracture gap and articular step-off, and ultimate failure load were measured.
RESULTS: The NHLP construct demonstrated significantly lower stiffness and a lower ultimate failure load compared to the TTLP and DRLP. During cyclic loading, no significant differences were observed in interval displacement among the groups; however, the cumulative displacement of the NHLP group was significantly greater than the other two (P < 0.001). All three constructs effectively maintained the articular surface, with no significant differences in fracture gap or anterior/central step-off. For posterior articular step-off, the NHLP provided superior control compared to the TTLP (P < 0.001) and was comparable to the DRLP.
CONCLUSION: In this biomechanical study of a Schatzker IV fracture model, the NHLP demonstrated lower overall stiffness and strength than conventional plates but provided superior stabilization of the posterior articular surface. The construct's ultimate strength was found to be sufficient for expected early postoperative physiological loads. The NHLP represents a biomechanically viable option for this fracture pattern, particularly given its design feature of sparing the pes anserinus.
CLINICAL TRIAL NUMBER: Not applicable.