Finite element analysis of the influence of fragment size on biomechanical outcomes of various fixation techniques for posterolateral tibial plateau fractures

Finite element analysis indicates that fragment size significantly affects the biomechanical stability of internal fixation for posterolateral tibial plateau fractures. For smaller fragments, L-shaped plate fixation with a single-screw transverse arm results in significantly elevated fixation stress. In contrast, posterior T-shaped plate fixation maintains favorable stability and lower stress, even with fewer proximal screws. Thus, for smaller posterolateral tibial plateau fracture fragments, posterior T-shaped plate fixation may represent a biomechanically superior option.