Journal article
Contact stress aberrations following imprecise reduction of simple tibial plateau fractures
Journal of orthopaedic research, Vol.6(6), pp.851-862
11/1988
DOI: 10.1002/jor.1100060609
PMID: 3171765
Abstract
Despite the well‐recognized association between poorly reduced intraarticular fractures and late degenerative changes, current guidelines regarding the reduction precision necessary to avoid excessive cartilage pressures are based largely on anecdotal clinical observations. To gain a quantitative appreciation of the relation between local pressure elevations and fracture reduction imprecision, a simplified laboratory cadaver model of minimally displaced tibial plateau fractures was developed. Cartilage contact stress distributions were measured as a function of depressed fragment malreduction in seven knees, using high‐resolution (100 pixels/mm2) digital image scans of Fuji‐film stain patterns. The contact stress data showed a general trend of increases of peak local pressure with increasing fracture site incongruity, and in a few isolated instances the effect was very pronounced. Across the whole series, however, statistically significant departures from anatomic pressure levels did not occur until the fragment stepoff was >1.5 mm. Even at the 3‐mm stepoff level, for which the depressed fragment usually no longer made contact with the femoral condyle, the peak local pressure values on the intact side of the fracture line averaged only ∼75% greater than those prevailing anatomically. Given the successful clinical outcomes normally achieved for conservatively managed simple tibial plateau fractures having stepoff magnitudes (5–10 mm) clearly sufficient to insure fragment articular noncontact, the present laboratory results suggest that nominally factor‐of‐two peak local pressure elevations, provided that they occur over only small portions of the cartilage surface, are probably within the long‐term overall tolerance range of an articular joint.
Details
- Title: Subtitle
- Contact stress aberrations following imprecise reduction of simple tibial plateau fractures
- Creators
- Thomas D BrownDonald D AndersonJames V NepolaRobert J SingermanDouglas R PedersenRichard A Brand
- Resource Type
- Journal article
- Publication Details
- Journal of orthopaedic research, Vol.6(6), pp.851-862
- Publisher
- Wiley Subscription Services, Inc., A Wiley Company; Hoboken
- DOI
- 10.1002/jor.1100060609
- PMID
- 3171765
- ISSN
- 0736-0266
- eISSN
- 1554-527X
- Number of pages
- 12
- Language
- English
- Date published
- 11/1988
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Industrial and Systems Engineering
- Record Identifier
- 9984040377002771
Metrics
19 Record Views