Biomechanical comparison of medial versus lateral sided plating in fractures of distal diaphysis of the femur. An in vitro experiment.

Firat Al, Bilgehan Tosun, Tamer Sinmazcelik, Mustafa Ozmen


Purpose: The aim of the present study was to determine if the application side 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 better biomechanically for the treatment of the fractures of distal diaphysis of the femur.
Materials and Methods: Stability and stiffness of medial sided plating relative to the conventional lateral sided in the distal diaphysis of the femur was 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 the fractures of the distal diaphysis of the femur by either medial or lateral sided plating. Axial loading was applied to samples by uniaxial testing machine.
Results: Yield and ultimate load values were higher in medial 15 cm group as to the lateral 15 cm. Yield load values of medial 18 cm group were higher than lateral 18 cm group, whereas ultimate load values were higher in lateral 18 cm group. There was statistically significant more implant deformation in lateral sided plating group.
Conclusions: Medial sided plating was found as stiff as lateral plating. Medial plating may be a reasonable treatment option that can be used safely in selective cases.

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