Biomechanical Comparison of Fixation Techniques in Midshaft Clavicular Fractures

Demirhan, Mehmet; Bilsel, Kerem; Atalar, Ata Can; Bozdağ, Ergün; Sünbüloğlu, Emin; Kale, Ayşin

doi:10.1097/bot.0b013e3181ee3db7

Cited by 45 publications

(48 citation statements)

References 26 publications

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“…This early failure may be due to using non-locking screws and formalin-fixed bones and is thus difficult to compare with our study [15]. In our study, a load of 80 N and the 1,000 cycles of cantilever bending did not challenge the implants up to their maximum load bearing capacity.…”

Section: Discussionmentioning

confidence: 51%

Biomechanical comparison of the Locking Compression superior anterior clavicle plate with seven and ten hole reconstruction plates in midshaft clavicle fracture stabilisation

Eden

Hoelscher-Doht

Frey

et al. 2012

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to characterise the biomechanical properties of the seven hole superior anterior clavicle LCP (locking compression plate) and to compare these with the properties of commonly applied implants used for the stabilisation of clavicular midshaft fractures such as the locking 7-and ten hole reconstruction plate. Methods Twenty-four synthetic clavicles were used. A transverse midshaft fracture was induced. The clavicles were fixed with angle stable clavicle LCPs, seven hole and ten hole reconstruction plates (n08 each). Twenty cycles of axial compression and torsion were performed for each sample, which was followed by 1,000 cycles of three point bending and ultimately bending to failure. Axial, torsional and cantilever bending stiffness were calculated from the data recorded. Results The clavicle LCP showed the highest overall stiffness compared to the seven and ten hole reconstruction plate. Significantly higher stiffness values were found for axial compression and external rotation. In the load-to-failure tests, the ten hole reconstruction plate especially showed early signs of plastic deformation, which might account for early plate insufficiency so frequently observed clinically. Conclusion The results indicate that the clavicle LCP, as compared to the reconstruction plates, leads to superior biomechanical stability in the treatment of midshaft clavicle fractures.

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Section: Discussionmentioning

confidence: 51%

Biomechanical comparison of the Locking Compression superior anterior clavicle plate with seven and ten hole reconstruction plates in midshaft clavicle fracture stabilisation

Eden

Hoelscher-Doht

Frey

et al. 2012

International Orthopaedics (SICOT)

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“…The radiological and clinical indications to perform osteosynthesis of mid-shaft clavicle fractures are still debated, and the suggested technique, choice of plate and position also vary in the literature [5,7,8,[10][11][12][13][14]. Despite the widespread use of locking plate osteosynthesis in clavicle fracture treatment, there is little clinical information about outcome and potential benefits of its use.…”

Section: Discussionmentioning

confidence: 99%

“…The locking plate theoretically offers increased stability of fixation, which again should allow for application of greater forces than conventional reconstruction or dynamic compression plates (DCP) plates. Biomechanical studies investigating the impact of torsional and bending load forces on both locking and DCP supports the concept that improved fixation is achieved when using a locking plate [7,8]. Clinical studies support advantages of locking plates over more conventional plate types [8][9][10].…”

Section: Introductionmentioning

confidence: 98%

Locking plate osteosynthesis of clavicle fractures: complication and reoperation rates in one hundred and five consecutive cases

Fridberg

Ban

Issa

et al. 2013

International Orthopaedics (SICOT)

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Purpose Locking plate osteosynthesis has become the preferred method for operative treatment of clavicle fractures. The method offers stable fixation, and would theoretically be associated with a low rate of fracture-related complications and reoperations. However, this remains to be explored in a large cohort, and our purpose was to assess the overall rates of complications and reoperations following locking plate osteosynthesis of mid-shaft clavicle fractures. Methods We identified all locking plate osteosynthesis of midshaft clavicle fractures operated upon in our department from January 2008 to November 2010 (n=114). Nine patients did not attend the follow-up at our institution. The study group of 105 fractures (104 patients, 86 males) had a median age of 36 years (14-75 years). Follow-up ranged from 0.5 to 3.5 years. No patients were allowed to load the upper extremity for six weeks. By studying patient files and radiographic material, we assessed complications and reoperations. Results Overall, there were 31 cases (30 %) of plate removals for discomfort. There were five cases (5 %) of failure of osteosynthesis: two occurred early after approximately six weeks and three late after ten to 13 months postoperatively. Conclusion The overall rate of failure of osteosynthesis is low (5 %). The burden of plate removals in approximately one third of patients should be included in the preoperative information.

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“…[16,17,22,23] Demirhan ve ark. [18] kadavra klavikulalarında yaptıkları deneysel çalışmada, kırık stabilizasyonunda plak vida yönteminin diğer osteosentez materyallerine göre daha stabil olduğunu göstermişlerdir. Kilitli klavikula plakları ile klasik dinamik kompresyon plaklarını karşılaştıran klinik çalışmalarda da kilitli anatomik plakların daha başarılı olduğu gösterilmiştir.…”

Section: Discussionunclassified

“…[12][13][14][15] Yapılan çalışmalar kırık redüksiyonu ve stabilite sağlamakta DCP (Dinamik kompresyon plakları) ve LC-DCP (kilitli ve dinamik kompresyonlu plak) arasında fark olmadığını göstermekle beraber LC-DCP plaklarının az temas yüzeyleri sayesinde periost dolaşımını bozmadığı ve kı-rık iyileşmesine pozitif etki ettiği gösterilmiştir. [16][17][18][19][20][21][22][23] Çalışmamızda kilitli anatomik klavikula plakları ile tedavi edilen klavikula kırıklarının radyolojik ve klinik sonuçlarını araştırdık. tedavi edilen 31 hastanın 32 klavikula cisim kırığı çalışmaya alındı.…”

Section: Introductionunclassified

The Results of Low Profile Locking Anatomical Plate Application for the Treatment of Edinburg Type 2 Clavicle Diaphysis Fractures

Akgül¹,

Zehir²,

Özdemir³

et al. 2014

Ulus Travma Acil Cerrahi Derg

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ÖZET AMAÇ: Klavikula kırıklarının tedavisinde kabul gören yaklaşım konservatif yöntemler olmakla beraber deplase ve parçalı kırıklarda cerrahi tedavi önerilmektedir. Cerrahi tedavide ise açık repozisyon ve plak vida uygulamaları yaygın olarak kullanılmaktadır. GEREÇ VE YÖNTEM:Çalışmamızda Edinburg tip 2b klavikula diyafiz kırığı olan, açık repozisyon ve anatomik kilitli klavikula plağı ile tedavi edilmiş olan 31 hastanın radyolojik ve klinik sonuçları geriye dönük olarak değerlendirildi. SONUÇ: Klavikula cisim kırıklarının cerrahi tedavisinde anatomik kilitli klavikula plakları ile fonksiyonel ve radyolojik olarak başarılı sonuçlar alınabilmektedir.Anahtar sözcükler: Klavikula diafiz kırığı; kilitli anatomik klavikula plağı.

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Biomechanical Comparison of Fixation Techniques in Midshaft Clavicular Fractures

Abstract: The locking plate is significantly more stable than DCP and Ex-fix under torsional and bending cyclic loading in a displaced fracture clavicle model.

Cited by 45 publications

References 26 publications

Biomechanical comparison of the Locking Compression superior anterior clavicle plate with seven and ten hole reconstruction plates in midshaft clavicle fracture stabilisation

Biomechanical comparison of the Locking Compression superior anterior clavicle plate with seven and ten hole reconstruction plates in midshaft clavicle fracture stabilisation

Locking plate osteosynthesis of clavicle fractures: complication and reoperation rates in one hundred and five consecutive cases

The Results of Low Profile Locking Anatomical Plate Application for the Treatment of Edinburg Type 2 Clavicle Diaphysis Fractures

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