Biomechanical Comparison Between Rim Plating and Posterior Buttress Plating for Posterolateral Tibia Plateau Fractures

Abstract This study aimed to evaluate the biomechanical efficacy of rim plating for posterolateral tibia plateau fractures (PLTPFs) compared to conventional posterior buttress plating. Sixty synthetic tibial models were divided into three groups: posterior buttress plating with a 3.5-mm locking compression T-plate, rim plating with a 2.7-mm variable-angle cloverleaf plate and two anteroposterior screws, and rim plating alone. Static compression and cyclic loading tests were conducted to assess mechanical stability under simulated physiological conditions. Failure loads averaged 2235.75 N, 2017.46 N, and 1743.95 N for the groups, respectively, all exceeding the 1500-N threshold corresponding to approximately 250% of body weight in vivo. Cyclic loading showed minimal displacements across groups, with no significant differences in stability. Rim plating demonstrated slightly lower failure loads than traditional posterior buttress plating but provided sufficient biomechanical support for PLTPFs. Its performance under both static and cyclic loading indicates it is a feasible alternative, offering adequate stability while potentially reducing surgical invasiveness. These findings support the consideration of rim plating as a practical option for optimizing PLTPF management, balancing mechanical requirements with less invasive surgical techniques.