🔍 Key Findings
- CBLO fixation with both a headless compression screw (HCS) and tension band (TB) showed the highest yield and ultimate loads compared to other configurations
- HCSTB constructs had significantly higher yield load (1212 N) and ultimate load (1388 N) than Plate alone (788 N, 774 N), HCS alone (907 N, 927 N), or TB alone (1016 N, 1076 N)
- No difference in construct stiffness was detected among the four fixation methods tested
- All constructs ultimately failed by bone fracture—location of failure differed by construct type (e.g., through HCS hole or cranial screw hole)
- TB and HCSTB groups showed failure via progressive TB stretching and cranial osteotomy widening, while Plate and HCS failed more abruptly
- All constructs withstood forces exceeding expected quadriceps load in vivo (170–325 N), suggesting all methods can resist physiological loading, but HCSTB provides greater safety margin
- HCS alone was not significantly stronger than Plate or TB alone, questioning its standalone superiority
- Study supports using TB and HCS together for optimal construct strength, but clinical studies are needed to validate implant fatigue, healing, and failure rates
