Anatomical analysis of different helical plate designs for distal femoral fracture fixation

Pastor, Torsten; Beeres, Frank J.P.; Kastner, Philipp; Gehweiler, Dominic; Migliorini, Filippo; Nebelung, Sven; Scaglioni, Mario F.; Souleiman, Firas; Link, Björn‐Christian; Babst, Reto; Gueorguiev, Boyko; Knobe, Matthias

doi:10.1016/j.injury.2022.03.033

Cited by 7 publications

(5 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, good clinical outcomes and safe feasibility of minimally invasively inserted supplemental medial helical plates were reported for distal femoral fractures 21 . This was confirmed in a recently published anatomical study applying the medial 90°‐helical plate with minimally invasive plate osteosynthesis (MIPO) technique 20 . The same applies to straight lateral plates which can be safely inserted with the same technique 35 .…”

Section: Discussionmentioning

confidence: 72%

“…21 This was confirmed in a recently published anatomical study applying the medial 90°-helical plate with minimally invasive plate osteosynthesis (MIPO) technique. 20 The same applies to straight lateral plates which can be safely inserted with the same technique. 35 However, inserting the additional medial straight plate with MIPO technique endangers the neurovascular structures of the thigh; therefore, 90°-helical plates should be used as they allow for minimally invasive surgery without endangering the critical anatomical structures of the medial thigh.…”

Section: Discussionmentioning

confidence: 99%

“…14,15 Hence, a helically shaped medial plate may be used to avoid damaging the vital structures of the thigh as already reported in several anatomic studies. [16][17][18][19][20] However, this concept has not been subjected to a direct biomechanical comparison against straight double plating so far. Therefore, the aim of the current study was to investigate the biomechanical competence of augmented lateral distal femoral plating using an additional straight versus a helically shaped medial plate in a paired human cadaveric bone model.…”

Section: Introductionmentioning

confidence: 99%

“…Helical plates have already proved useful for the treatment of proximal humeral shaft fractures 14,15 . Hence, a helically shaped medial plate may be used to avoid damaging the vital structures of the thigh as already reported in several anatomic studies 16–20 . However, this concept has not been subjected to a direct biomechanical comparison against straight double plating so far.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Is augmented femoral lateral plating with helically shaped medial plates biomechanically advantageous over straight medial plates?

Pastor,

Zderic,

Drenchev

et al. 2023

Journal Orthopaedic Research

Self Cite

View full text Add to dashboard Cite

BackgroundDual plating of comminuted distal femoral fractures allows for early patient mobilization. An additional helically shaped medial plate avoids the medial vital structures of the thigh. Aim: to investigate the biomechanical competence of augmented lateral locking compression plate distal femur (LCP‐DF) using an additional straight versus a helically shaped medial LCP of the same length.MethodsTen pairs of human cadaveric femora were instrumented with a lateral anatomical 15‐hole LCP‐DF. Following, they were pairwise instrumented with either an additional medial straight 14‐hole LCP (group1) or a 90°‐helical shape LCP (group2). All specimens were biomechanically tested under quasi‐static and progressively increasing combined cyclic axial and torsional loading until failure.ResultsInitial interfragmentary axial displacement and flexion under static compression were significantly smaller in group1 (0.11±0.12mm and 0.21±0.10°) versus group2 (0.31±0.14mm and 0.68±0.16°), p≤0.007. Initial varus deformation under static compression remained not significantly different between group1 (0.57±0.23°) and group2 (0.75±0.34°), p=0.085. Flexion movements during dynamic loading were significantly higher for group2 (2.51±0.54°) versus group1 (1.63±1.28°), p=0.015, however, no significant differences were observed in terms of varus, internal rotation, axial and shear displacements between the groups, p≥0.204. Cycles to failure and load at failure were higher in group2 (25172±6376 and 3017N±638N) compared to group1 (22277±4576 and 2728N±458N) with no significant differences between them, p=0.195.ConclusionFrom a biomechanical perspective, helical double plating may be considered as useful alternative to straight double plating, demonstrating ameliorated damping capacities during flexion deformation and safer application as the medial neurovascular structures of the thigh are avoided.This article is protected by copyright. All rights reserved.

show abstract

Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Is augmented femoral lateral plating with helically shaped medial plates biomechanically advantageous over straight medial plates?

Pastor,

Zderic,

Drenchev

et al. 2023

Journal Orthopaedic Research

Self Cite

View full text Add to dashboard Cite

show abstract

“…Additional human cadaveric biomechanical studies are needed to evaluate the competence of different plate designs, especially of the 45 • -helical plate, via cyclic testing. Furthermore, future biomechanical research might investigate the application of helical plate design for fixation of femoral fractures, as an anatomical evaluation already demonstrated the safety and feasibility of its usage [36].…”

Section: Discussionmentioning

confidence: 99%

Helical Plating Compared with Straight Plating and Nailing for Treatment of Proximal Third Humeral Shaft Fractures—A Biomechanical Study

Pastor,

Zderic,

Pastor

et al. 2023

Medicina

Self Cite

View full text Add to dashboard Cite

Background and Objectives: The surgical treatment of proximal humeral shaft fractures usually considers application of either long straight plates or intramedullary nails. By being able to spare the rotator cuff and avoid the radial nerve distally, the implementation of helical plates might overcome the downsides of common fixation methods. The aims of the current study were (1) to explore the biomechanical competence of different plate designs and (2) to compare their performance versus the alternative treatment option of using intramedullary nails. Materials and Methods: Twenty-four artificial humeri were assigned to the following four groups for simulation of an unstable proximal humeral shaft fracture and instrumentation: Group 1 (Straight-PHILOS), Group 2 (MULTILOC-Nail), Group 3 (45°-Helical-PHILOS), and Group 4 (90°-Helical-PHILOS). All specimens underwent non-destructive, quasi-static biomechanical testing under loading in axial compression, torsion in internal/external rotation, and pure bending in four directions, accompanied by motion tracking. Results: Axial stiffness/displacement in Group 2 was significantly higher/smaller than in all other groups (p ≤ 0.010). Torsional displacement in Group 2 was significantly bigger than in all other groups (p ≤ 0.017). Significantly smaller coronal plane displacement was identified in Group 2 versus all other groups (p < 0.001) and in Group 4 versus Group 1 (p = 0.022). Significantly bigger sagittal plane displacement was detected in Group 4 versus all other groups (p ≤ 0.024) and in Group 1 versus Group 2 (p < 0.001). Conclusions: Intramedullary nails demonstrated higher axial stiffness and smaller axial interfragmentary movements compared with all investigated plate designs. However, they were associated with bigger torsional movements at the fracture site. Although 90°-helical plates revealed bigger interfragmentary movements in the sagittal plane, they demonstrated improved resistance against displacements in the coronal plane when compared with straight lateral plates. In addition, 45°-helical plates manifested similar biomechanical competence to straight plates and may be considered a valid alternative to the latter from a biomechanical standpoint.

show abstract

Biomechanical analysis of helical versus straight plating of proximal third humeral shaft fractures

Pastor

Knegsel

Beeres

et al. 2023

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

Anatomical analysis of different helical plate designs for distal femoral fracture fixation

Cited by 7 publications

References 26 publications

Is augmented femoral lateral plating with helically shaped medial plates biomechanically advantageous over straight medial plates?

Is augmented femoral lateral plating with helically shaped medial plates biomechanically advantageous over straight medial plates?

Helical Plating Compared with Straight Plating and Nailing for Treatment of Proximal Third Humeral Shaft Fractures—A Biomechanical Study

Biomechanical analysis of helical versus straight plating of proximal third humeral shaft fractures

Contact Info

Product

Resources

About