OBJECTIVETo assess the clinical effects of Ni-Ti shape memory alloy bow-teeth screws combined with locking plate internal fixation in treating comminuted fracture of tibial plateau.

METHODSFrom January 2003 to December 2008, 17 patients with comminuted fracture of tibial plateau were treated with Ni-Ti shape memory alloy bow-teeth screws and locking plate internal fixation. There were 9 males and 8 females with an average age of 33.7 years old (ranged, 23 to 48 years). All fractures were fresh and injured time less 3 weeks and 2 patients with common peroneal nerve injury. According to Schatzker typing, type V was in 1 case and type VI was in 16 cases.

RESULTSAll patients were followed up from 10 to 22 months with an average of 18 months and all incisions healed in one stage. At 3 to 12 weeks after operation, knee joint function of 16 cases arrived to the level of uninjured side and 1 case was poor in flexed function. All fractures obtained union at 3 to 5 months after operation, and internal fixtures were removed at 1 year after operation and no reduction lossing or refracture occurred. At final follow-up, no bone block shifting, internal fixture loosening and breakage was found. According to the standard of Xushanding's knee joint function, 9 cases got excellent results, 4 good, 4 fair.

CONCLUSIONThe design of Ni-Ti shape memory alloy bow-teeth screws is adapt to irregular anatomic structure of comminuted fractures of tibial plateau,it can continuously pressurize and promote bone healing. Multi drop lockedup may avoid wide-ranging stripping local soft tissue, and form three-dimension fixation after combined with locking plate internal fixation, can effective recover anatomic structure of fracture. So Ni-Ti shape memory alloy bow-teeth screws combined with locking plate internal fixation is an effective method in treating comminuted fracture of tibial plateau.