Impact of screw reinsertion on osteosynthesis stability in Schatzker IV tibial plateau fractures: a biomechanical study.

IF 1.8 Q2 ORTHOPEDICS
SICOT-J Pub Date : 2025-01-01 Epub Date: 2025-02-27 DOI:10.1051/sicotj/2025008
Shuhei Hiyama, Tsuneari Takahashi, Jiro Ando, Yoshiya Nibe, Tomohiro Matsumura, Katsushi Takeshita
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Abstract

Introduction: This biomechanical study evaluated the effect of screw reinsertion with a locking plate on fixation strength and the stability of osteosynthesis in medial tibial plateau fractures using porcine bone.

Materials and methods: Thirty porcine tibiae were divided into three groups: group A (underwent biomechanical testing after medial tibial fixation with a large fragment T-shaped locking plate), group B (underwent plate fixation, followed by the removal of all screws and plates and refixation with the same screws and plates using the same holes before biomechanical testing), and group C (underwent biomechanical testing once after plate fixation, followed by the removal of all screws and plates, refixation with the same screws and plates using the same holes, and then biomechanical testing). The translation pattern of the constructs in each group was examined using cyclic loading tests. The changes in the joint gap and step-off after 2000 cycles were compared among the three groups.

Results: Significant differences in displacement were observed at 10-100 cycles (group A: -0.01 ± 0.04 mm, group B: -0.02 ± 0.04 mm, group C: -0.13 ± 0.15 mm, P = 0.021). However, no significant differences were found in other displacement and translation measurements among the groups. Regarding the gap and step-off among groups, significant differences were observed in anterior and posterior gap changes. Despite the statistical significance, the absolute displacement values were small, suggesting minimal clinical relevance. These findings indicate that reinserting screws and plates into the same hole may not substantially compromise overall fixation strength.

Conclusion: Screw reinsertion in the same holes after removal did not significantly compromise the stability of osteosynthesis in this biomechanical model. These findings suggest that reinsertion may be a viable option in revision surgery.

Schatzker IV型胫骨平台骨折再钉对骨整合稳定性的影响:生物力学研究。
简介:本生物力学研究评估了猪骨胫骨内侧平台骨折再置入锁定钢板螺钉对固定强度和骨合成稳定性的影响。材料与方法:30只猪胫骨分为3组:A组(胫骨内侧用大碎片t型锁定钢板固定后进行生物力学试验),B组(钢板固定后取出所有螺钉和钢板,在生物力学试验前使用相同孔用相同螺钉和钢板再固定),C组(钢板固定后进行一次生物力学试验,取出所有螺钉和钢板,使用相同孔用相同螺钉和钢板再固定。然后是生物力学测试)。采用循环加载试验检测各组构念的翻译模式。比较三组在2000个周期后关节间隙和步距的变化。结果:在10 ~ 100个周期内,位移量差异有统计学意义(A组:-0.01±0.04 mm, B组:-0.02±0.04 mm, C组:-0.13±0.15 mm, P = 0.021)。然而,在其他位移和平移测量中,各组之间没有发现显着差异。对于间隙和步离,组间前后间隙变化有显著性差异。尽管有统计学意义,但绝对位移值很小,表明临床相关性很小。这些结果表明,在同一孔内重新插入螺钉和钢板可能不会显著降低整体固定强度。结论:在该生物力学模型中,拆除后在相同孔内重新插入螺钉不会显著影响骨结合的稳定性。这些发现提示在翻修手术中重新插入可能是一个可行的选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
SICOT-J
SICOT-J ORTHOPEDICS-
CiteScore
3.20
自引率
12.50%
发文量
44
审稿时长
14 weeks
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