Equilibrium Mechanics in Fracture Reduction of Tibial Plateau

Abstract

Background: Tibial plateau fracture is one of the common fractures in the lower limb, mostly caused by high-energy injuries, which may be accompanied by different degrees of compression and displacement of the joint surface, affecting the knee joint alignment, stability, and sports function, and improper treatment may cause various complications, which are a more difficult problem in the clinic. The objective of this study was to investigate the biomechanical mechanisms underlying effective closed reduction in the treatment of tibial plateau fractures, particularly focusing on the performance of the homeopathic double reverse traction repositor compared to traditional traction table methods.

Methods: We developed a biomechanical model to analyze the equilibrium mechanics during tibial plateau fracture reduction. A quantitative analysis was performed to evaluate the mechanical forces involved in both the traditional traction table method and the double reverse traction repositor.

Results: Our analysis revealed that the use of a traction table generates an additional bending moment at the tibial plateau, resulting in medial over-distraction and lateral compression. This mechanical imbalance can obstruct fracture reduction and irritate surrounding soft tissues. In contrast, the double reverse traction repositor avoids these adverse forces, reducing soft tissue irritation and improving reduction efficiency by utilizing equilibrium mechanics.

Conclusion: The double reverse traction repositor offers a biomechanical advantage in the reduction of tibial plateau fractures by creating a more balanced mechanical environment. This study enhances the understanding of fracture reduction mechanics and supports the repositor's use not only for tibial plateau fractures but also for other fracture types, such as intertrochanteric, extremity long bone, and comminuted fractures.

Keywords

double reverse traction repositor / equilibrium mechanics / homeopathic repositioning theory / minimally invasive therapy / tibial plateau fractures

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2025 The Author(s). Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.