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Journal of Trauma and Injury 2013;26(3):163-169.
Anatomic Conformity of New Periarticular Locking Plates for Koreans: A Biomechanical Cadaveric Study
Yong Cheol Yoon, Jong Keon Oh, Young Woo Kim, Hak Jun Kim, Hong Joo Moon, Nam Ryeol Kim
1Department of Orthopedic Surgery, Korea University College of Medicine, Korea. jkoh@korea.ac.kr
2Department of Neurosurgery, Korea University College of Medicine, Korea.
3Department of General Surgery, Korea University College of Medicine, Korea.
한국인에 대한 새로운 관절주위 잠김금속판의 해부학적 적합성: 사체를 이용한 연구
윤용철, 오종건, 김영우, 김학준, 문홍주1, 김남렬2
고려대학교 구로병원 정형외과학교실, 1신경외과학교실, 2외과학교실
Received: 16 June 2013   • Revised: 7 July 2013   • Accepted: 2 September 2013
Abstract
PURPOSE
This study was conducted to confirm the anatomic conformity of the new periarticular locking plates designed by Zimmer on Korean adult bones and to identify the structures at risk during the application of these implants.
METHODS
The study was performed on the humerus, radius, and tibia of 10 adult cadavers(6 males and 4 females) procured from the cadaveric lab of our hospital. Anteroposterior (AP) and lateral X-rays were taken to confirm that the cadavers were free of any unusual lesions or anatomic variations. We used the 3.5-mm proximal humerus plate, 2.7-mm distal radius plate, 3.5- and 5.0-mm proximal tibia plates, and 3.5-mm distal tibia plate developed by Zimmer, Inc. (Zimmer periarticular locking plate). The longest plate from each group was used to confirm anatomical conformity. Standard approaches were used for each area, and soft tissue was retracted in order to pass the plate beneath the muscle. The position of the plate was confirmed using standard AP and lateral view X-rays. After this procedure had been completed, the region was dissected along the length of the implant to determine the conformity of the implant to bone and the penetrations of screws into the articular surface or violations of any vital structures, such as nerves, blood vessels, or tendons.
RESULTS
Excellent anatomical conformity was observed with Zimmer periarticular locking plates for Korean adults. The tibial nerve and the posterior tibial artery were found to be structures at risk when applying a distal tibial plate.
CONCLUSION
Additional posterolateral fixation is recommended when dealing with cases of tibial plateau fracture when the fracture line extends to the posterolateral cortex. We recommend taking proper views using 10~15 degrees of internal rotation to ensure correct screw length and, thus, avoid penetration of vital structures and tendons.
Key Words: Biomechanics; Cadaver
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