{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T01:23:54Z","timestamp":1781659434518,"version":"3.54.5"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2005,2,18]],"date-time":"2005-02-18T00:00:00Z","timestamp":1108684800000},"content-version":"vor","delay-in-days":5953,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[1988,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Despite the well\u2010recognized association between poorly reduced intraarticular fractures and late degenerative changes, current guidelines regarding the reduction precision necessary to avoid excessive cartilage pressures are based largely on anecdotal clinical observations. To gain a quantitative appreciation of the relation between local pressure elevations and fracture reduction imprecision, a simplified laboratory cadaver model of minimally displaced tibial plateau fractures was developed. Cartilage contact stress distributions were measured as a function of depressed fragment malreduction in seven knees, using high\u2010resolution (100 pixels\/mm<jats:sup>2<\/jats:sup>) digital image scans of Fuji\u2010film stain patterns. The contact stress data showed a general trend of increases of peak local pressure with increasing fracture site incongruity, and in a few isolated instances the effect was very pronounced. Across the whole series, however, statistically significant departures from anatomic pressure levels did not occur until the fragment stepoff was &gt;1.5 mm. Even at the 3\u2010mm stepoff level, for which the depressed fragment usually no longer made contact with the femoral condyle, the peak local pressure values on the intact side of the fracture line averaged only \u223c75% greater than those prevailing anatomically. Given the successful clinical outcomes normally achieved for conservatively managed simple tibial plateau fractures having stepoff magnitudes (5\u201310 mm) clearly sufficient to insure fragment articular noncontact, the present laboratory results suggest that nominally factor\u2010of\u2010two peak local pressure elevations, provided that they occur over only small portions of the cartilage surface, are probably within the long\u2010term overall tolerance range of an articular joint.<\/jats:p>","DOI":"10.1002\/jor.1100060609","type":"journal-article","created":{"date-parts":[[2005,2,24]],"date-time":"2005-02-24T12:50:41Z","timestamp":1109249441000},"page":"851-862","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":163,"title":["Contact stress aberrations following imprecise reduction of simple tibial plateau fractures"],"prefix":"10.1002","volume":"6","author":[{"given":"Thomas 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