Abstract
BACKGROUND: This study investigated the impact of higher interfragmentary compression force (IFCF) on the stability of locking plate fixation in lateral tibial plateau fractures. METHODS: Biomechanical experiments and finite element analysis (FEA) were employed to compare the performance of the AO cancellous lag screw (AOCLS) and a newly developed combined cancellous lag screw (CCLS). RESULTS: The results demonstrated that the CCLS provided a higher IFCF without the risk of over-screwing, significantly improving fixation stability. High IFCF markedly increased the initial axial stiffness, allowing for earlier weight-bearing in patients. Additionally, the FEA showed that increased IFCF reduced the peak von Mises stress on implants and the peak equivalent elastic strain on the lateral fragment, thereby enhancing overall structural stability. CONCLUSIONS: These findings suggested that the CCLS, with its superior IFCF and reduced risk of over-screwing, was a promising option for improving fixation stability in lateral tibial plateau fractures. This improvement could facilitate early rehabilitation, minimise complications, and provide better clinical outcomes. These results provide strong scientific evidence for the clinical use of CCLS.