Biomechanical comparison of screw versus screw-plate fixation of type 2 Schatzker fractures of the lateral tibial plateau

Purpose of the study We compared in vitro the efficacy of screw-plate fixation versus double scr ew fixation on a model of type 2 Schatzker fracture of the lateral tibial p lateau. Materials and methods Ten screw-plate fixations using a lateral prebent plate and 10 double-screw fixations (6.5 mm screws) were made on 10 pairs of non-embalmed cadaver kn ees after simulation of type 2 Schatzker fractures. The strength of each fi xation was tested with a compression device. Criteria indicating failure we re displacements greater than 2 mm of one or more fracture lines. The force applied at rupture and the stiffness of each type of fixation were compare d. Wilcoxon's test was used for statistical analysis. Results Force at rupture and stiffness of the fixation were similar for the two typ es of fixation. There was no statistical difference (p > 0.05) between the screw-plate and the double-screw fixations. Discussion Our findings on a model of type 2 Schatzker fractures are in agreement with previous data obtained by other authors working on models of type 1 Schats ker fractures. The biomechanical stability of the double-screw fixation is as good as that obtained with screw-plate fixation for the treatment of fra ctures of the lateral tibial plateau.