Stress and stability of newly designed medial anatomic locking plates and traditional fixations in the treatment of posterointernal tibial plateau fracture : a comparative finite element study

Purpose: This study aimed to analyze the biomechanical stability of a new designed plate for posterointernal tibial plateau fracture fixation, and compare with traditional fixation implants, including cancellous screws and a L-shape locking plate. Methods: A posterointernal tibial plateau fracture three-dimensional (3D) model was reconstructed by finite element analysis (FEA) software. A 400 N axis load was created with a 60% distribution on the medial tibial plateau surface, while the distal end of tibia was fully fixed, to simulate the bipedal static stance. Equivalent von Mises stress (EVMS), displacement and equivalent maps of displacement and stress of the models fixed by different fixations were output for comparison. Results: The maximal stress of the cancellous screw group, the L-shape locking plate group and the newly designed plate group was 4.4178 MPa, 9.7438 MPa and 20.1355 MPa, respectively. Peak displacement of three groups was all less than 2 mm which was usually to evaluate whether reduction of the fracture was successful. Conclusions: This study illustrates that newly designed anatomic locking plates have superior performance in posterointernal tibial plateau fracture fixation and serve as a suitable clinical alternative fixation method.