BIOMECHANICAL COMPARISON OF MEDIAL VERSUS LATERAL SIDED PLATING IN FEMORAL FRACTURES

ABSTRACT Objective: The aim of the present study was to determine whether the side of application of the plate itself affects the mechanical stability of the fixation. The specific question addressed is whether or not a lateral or medial plate application is biomechanically better, for the treatment of distal diaphysis fractures of the femur. Methods: Stability and stiffness of medial sided plating relative to the conventional lateral sided plating in distal diaphysis of the femur were measured by analyzing axial loading forces leading to implant failure. Sixty synthetic femurs were tested in physiological bending, to calculate the yield and ultimate load to displacement following fixation of distal diaphysis fractures of the femur by either medial or lateral sided plating. Axial loading was applied to samples using a uniaxial testing machine. Results: There was more implant deformation in the lateral sided plating group – a difference with statistical significance. Conclusion: Medial sided plating was found to be as stiff as lateral plating. Medial plating may be a reasonable treatment option that can be used safely in selected cases. Level of Evidence I, Therapeutic Studies Investigating the Results of Treatment

摘要 研究目的：本研究旨在明确钢板置入侧是否会影响内固定的力学稳定性，具体探讨股骨远端骨干骨折治疗中，采用内侧或外侧钢板置入是否在生物力学上更具优势。
方法：通过分析导致内置物失效的轴向加载载荷，对比股骨远端骨干骨折采用内侧钢板置入与常规外侧钢板置入的稳定性与刚度。本研究纳入60根合成股骨，分别采用内侧或外侧钢板固定股骨远端骨干骨折后，进行生理弯曲载荷测试，计算屈服载荷与极限位移载荷。采用单轴试验机对所有样本施加轴向加载载荷。
结果：外侧钢板置入组的内置物变形量更大，该差异具有统计学意义。
结论：内侧钢板置入与外侧钢板置入的刚度相当。内侧钢板置入可作为合理的治疗选择，在严格筛选的病例中可安全应用。证据等级：I级，治疗效果研究。