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

Abstract

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.

Strength analysis of clavicle fracture fixation devices and fixation techniques using finite element analysis with musculoskeletal force input

“…Opinions are divided regarding the optimal treatment of clavicle fractures but displaced mid-shaft fractures of the clavicle gain more and more importance in the field of orthopedic surgery [3]. When the clavicle fractures are treated operatively, there is also varying opinions about the best fixation device and strategy.…”

“…Opinions differ on how often clavicle fractures should be operated on or treated non-operatively and about what kind of fixation device and technique to use when operating [3][4][5]. The interaction of muscles and ligaments in the shoulder region is complex.…”

“…Perform sensitivity analysis to study the impact on resulting stresses and displacements due to simplifications of the model. 3. Use the modified model to perform comparative stress analyses between different clavicle fixation devices and strategies.…”

Significant pain reduction and improved functional outcome after surgery for displaced midshaft clavicular fractures

“…By 2008, 26 % of all midshaft clavicular fractures were already treated operatively in Germany [6] mainly using reconstruction plates. We, however, observed a high rate of implant failure and less biomechanical stability using reconstruction plates [7]. Since then, the new plates (Locking compression plate (LCP) anterior-superior clavicle plate, Fa.…”

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

“…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]. Despite the frequent use of locking plates, little is known about what rates of complications and reoperations to expect following the use of this technique in daily practice [6].…”