BIOMECHANICAL BEHAVIOR AT THE DISTAL 3RD OF THE FEMUR - POSSIBLE USE OF A MEDIAL METAPHYSEAL PLATE

The incidence of fractures ill the distal femur is becoming more frequ ent and they are often associated to complex lesions with potential co mplications. Operative treatment a mandatory for elderly people and se veral methods of internal fixation with appropriate implants have been developed, generally approaching the lateral aspect of the femur.. Ai l alternative antero-medial access was proposed several years ago but the biomechanical aspects of its application must be debated. The aim of the present study is to establish if adverse biomechanical effects should be expected when the plate is affixed at the medial side of the femur metaphysis, by analysing the strain pattern of a human cadaver femur submitted to loads simulated in different experimental condition s. Application of load resulted, as expected, ill tension in rile late ral aspect and compression ii? the medial aspect of the femur diaphysi s, but it turned more and more toward the anterior aspect and the comp ression turned toward the posterior aspect when the levels measured ch anged from proximal to distal. The plate was next to the neutral axis and produced a moderate stress production effect (approx. 70 per cent) . No biomechanical disadvantages have been observed as a result of the plate being apposed at the medial aspect instead of the conventional lateral aspect of the distal femur. (C) 1998 Elsevier Science Ltd. All rights reserved.