BACKGROUND This study aimed to investigate the biomechanical effect on the Takeuchi classification of lateral hinge fracture (LHF) after an opening wedge high tibial osteotomy (HTO). METHODS We performed an FE simulation for type I, type II, and type III in accordance with the Takeuchi classification. The stresses on the bone and plate, wedge micromotion, and forces on ligaments were evaluated to investigate stress-shielding effect, plate stability, and biomechanical change, respectively, in three different types of LHF HTO and with the HTO without LHF model (non-LHF) models. RESULTS The greatest stress-shielding effect and wedge micromotion were observed in type II LHF (distal portion fracture). The type II and type III (lateral plateau fracture) models exhibited a reduction in ACL force and an increase in PCL force compared with the HTO without LHF model. However, the type I (osteotomy line fracture) and HTO without LHF models did not exhibit a significant biomechanical effect. This study demonstrates that Takeuchi type II and type III LHF models provide unstable structures compared with the type I and HTO without LHF models. CONCLUSIONS HTO should be performed while considering a medial opening wedge HTO to avoid a type II and type III LHF as a potential complication.

中文翻译：

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外侧铰链骨折对内侧开口楔形高胫骨截骨术的生物力学影响：有限元研究。

背景技术本研究旨在探讨对楔形高位胫骨截骨术（HTO）后外侧铰链骨折（L​​HF）的Takeuchi分类的生物力学作用。方法我们根据Takeuchi分类对I型，II型和III型进行了有限元模拟。分别评估了三种不同类型的LHF HTO和使用无LHF模型的HTO（非- LHF）模型。结果在II型LHF（远端骨折）中观察到最大的应力屏蔽效果和楔形微动。与没有LHF模型的HTO相比，II型和III型（外侧平台骨折）模型显示出ACL力减小和PCL力增加。但是，没有LHF模型的I型（切骨线骨折）和HTO并未表现出明显的生物力学作用。这项研究表明，与没有LHF模型的I型和HTO相比，Takeuchi II型和III型LHF模型提供的结构不稳定。结论HTO应在考虑内侧楔形HTO的同时进行，以避免II型和III型LHF作为潜在并发症。这项研究表明，与没有LHF模型的I型和HTO相比，Takeuchi II型和III型LHF模型提供的结构不稳定。结论HTO应在考虑内侧楔形HTO的同时进行，以避免II型和III型LHF作为潜在并发症。这项研究表明，与没有LHF模型的I型和HTO相比，Takeuchi II型和III型LHF模型提供的结构不稳定。结论HTO应在考虑内侧楔形HTO的同时进行，以避免II型和III型LHF作为潜在并发症。