Biomechanical testing of a new plate system for the distal humerus compared to two well-established implants

Voigt, C.; Rank, Christina; Waizner, Klaus; Wendlandt, Robert; Unger, Andreas; Schulz, Arndt P.; Jürgens, Christian; Renken, Felix

doi:10.1007/s00264-013-1779-7

Cited by 11 publications

(9 citation statements)

References 17 publications

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“…25 The forces during the elbow motion are difficult to quantify because of the complex interplay of muscles. 31 In different biomechanical analyses of internal fixation of the distal humerus, a load of 150 N 19,23 and 200 N 32 was used. During normal daily activity, forces of up to 300 N act on the arm.…”

Section: Discussionmentioning

confidence: 99%

“…The basis for this calculation was the results of a previously conducted study with a similar study design. 19 We estimated a necessary sample size of eight per group (calculation parameters: significance level α = 0.05, SD = 15, effect = 21, statistical power = 0.8). The recorded data were saved in an Excel spreadsheet and analyzed in cooperation with a statistician employing SPSS, version 20 (IBM Corp., Armonk, NY, USA).…”

Section: Methodsmentioning

confidence: 99%

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Biomechanical testing of a novel osteosynthesis plate for the ulnar coronoid process

Kiene¹,

Bogun²,

Brockhaus³

et al. 2014

Shoulder & Elbow

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Biomechanical testing of a novel osteosynthesis plate for the ulnar coronoid process

Kiene¹,

Bogun²,

Brockhaus³

et al. 2014

Shoulder & Elbow

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“…Additionally, this provides mechanical stability without the need for the plate to match the curvature of the bone surface and to compress and maintain friction with the bone surface [1,15,21]. As compared to a compression plate construct, the locked screws in a locking plate construct have been reported to decrease the incidence of construct failure from screw loosening [22].…”

Section: Discussionmentioning

confidence: 99%

Dual small fragment plating improves screw-to-screw load sharing for mid-diaphyseal humeral fracture fixation: A finite element study

Kosmopoulos

Luedke

Nana

2014

THC

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BACKGROUND: A smaller humerus in some patients makes the use of a large fragment fixation plate difficult. Dual small fragment plate constructs have been suggested as an alternative. OBJECTIVE: This study compares the biomechanical performance of three single and one dual plate construct for middiaphyseal humeral fracture fixation. METHODS: Five humeral shaft finite element models (1 intact and 4 fixation) were loaded in torsion, compression, posterioranterior (PA) bending, and lateral-medial (LM) bending. A comminuted fracture was simulated by a 1-cm gap. Fracture fixation was modelled by: (A) 4.5-mm 9-hole large fragment plate (wide), (B) 4.5-mm 9-hole large fragment plate (narrow), (C) 3.5-mm 9-hole small fragment plate, and (D) one 3.5-mm 9-hole small fragment plate and one 3.5-mm 7-hole small fragment plate. RESULTS: Model A showed the best outcomes in torsion and PA bending, whereas Model D outperformed the others in compression and LM bending. Stress concentrations were located near and around the unused screw holes for each of the single plate models and at the neck of the screws just below the plates for all the models studied. Other than in PA bending, Model D showed the best overall screw-to-screw load sharing characteristics. CONCLUSION: The results support using a dual small fragment locking plate construct as an alternative in cases where crutch weight-bearing (compression) tolerance may be important and where anatomy limits the size of the humerus bone segment available for large fragment plate fixation.

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“…The mechanical test procedure was modified from a previous biomechanical study [ 21 ]. First, each specimen was preloaded to 50 N at a speed of 1 mm/min for 5 cycles.…”

Section: Methodsmentioning

confidence: 99%

Does posterior configuration have similar strength as parallel configuration for treating comminuted distal humerus fractures? A cadaveric biomechanical study

Shih

Kuan

Hsu

et al. 2021

BMC Musculoskelet Disord

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Background The posterior plating technique could be used as a clinical alternative to parallel plating for treating comminuted distal humerus fractures (DHFs) successfully with good clinical results. However, the biomechanical characteristics for posterior fixation are still unclear. The purpose of this study is to evaluate the biomechanical properties of the posterior fixation and to make comparisons between the parallel and the posterior fixation systems. Materials and methods We performed a cadaveric biomechanical testing with two posterior plating systems (a posterior two plating and a single posterior pre-contoured Y plating system) and one parallel two plating system to treat AO/OTA type-C2.3 DHFs. Among three groups, we compared construct stiffness, failure strength, and intercondylar width changes after 5000-cycle fatigue loading and failure loads and failure modes after destructive tests in both the axial compression and (sagittal) posterior bending directions. The correlations between construct failure loads and bone marrow density (BMD) were also compared. Results In axial direction, there were no significant differences in the stiffness and failure load between the posterior and the parallel constructs. However, in sagittal direction, the two-plate groups (posterior two plating and parallel plating group) had significant higher stiffness and failure loads than the one-plate group (single posterior Y plating). There was no fixation failure after 5000-cyclic loading in both directions for all groups. Positive correlation was noted between BMD and failure loads on parallel fixation. Conclusions We found that when using two plates for treating comminuted DHFs, there were no significant differences in terms of most biomechanical measurements between posterior and parallel fixation. However, the single pre-contoured posterior Y plate construct was biomechanically weaker in the sagittal plane than the parallel and the posterior two-plate constructs, although there was no fixation failure after the fatigue test for all groups regardless of the fixation methods. Level of evidence Biomechanical study

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Biomechanical testing of a new plate system for the distal humerus compared to two well-established implants

Abstract: The hypothesis that the newly designed plate system showed comparable results in the quasi-static and dynamic tests compared to the conventional implants with a significantly lower implant volume and thickness was confirmed.

Cited by 11 publications

References 17 publications

Biomechanical testing of a novel osteosynthesis plate for the ulnar coronoid process

Biomechanical testing of a novel osteosynthesis plate for the ulnar coronoid process

Dual small fragment plating improves screw-to-screw load sharing for mid-diaphyseal humeral fracture fixation: A finite element study

Does posterior configuration have similar strength as parallel configuration for treating comminuted distal humerus fractures? A cadaveric biomechanical study

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