Comparison of 3.5 locking compression plate fixation to 3.5 limited contact dynamic compression plate fixation

Filipowicz, Dean E.; Lanz, Otto I.; McLaughlin, Richard A.

doi:10.3415/vcot-10-01-0006

Cited by 2 publications

(3 citation statements)

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“…Double-locked versus nonlocked plates for IAFs usually had more axial stiffness, bending stiffness, axial strength, and/or axial fatigue life, as well as less fracture motion, in high and low-density bone [ 38 , 44 , 52 ], but there were some exceptions in high-density bone [ 38 ]. Single- or double-locked versus nonlocked plates for EAFs sometimes had higher or lower fracture motion, stiffness, and/or strength during various loading modes, possibly due to variations in comminution and study protocol [ 59 , 61 , 63 , 69 , 70 ].…”

Section: Resultsmentioning

confidence: 99%

Biomechanical Design Optimization of Distal Humerus Fracture Plates: A Review

Zdero,

Brzozowski,

Schemitsch

2024

BioMed Research International

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The goal of this article was to review studies on distal humerus fracture plates (DHFPs) to understand the biomechanical influence of systematically changing the plate or screw variables. The problem is that DHFPs are commonly used surgically, although complications can still occur, and it is unclear if implant configurations are always optimized using biomechanical criteria. A systematic search of the PubMed database was conducted to identify English‐language biomechanical optimization studies of DHFPs that parametrically altered plate and/or screw variables to analyze their influence on engineering performance. Intraarticular and extraarticular fracture (EAF) data were separated and organized under commonly used biomechanical outcome metrics. The results identified 52 eligible DHFP studies, which evaluated various plate and screw variables. The most common plate variables evaluated were geometry, hole type, number, and position. Fewer studies assessed screw variables, with number and angle being the most common. However, no studies examined nonmetallic materials for plates or screws, which may be of interest in future research. Also, articles used various combinations of biomechanical outcome metrics, such as interfragmentary fracture motion, bone, plate, or screw stress, number of loading cycles to failure, and overall stiffness (Os) or failure strength (Fs). However, no study evaluated the bone stress under the plate to examine bone “stress shielding,” which may impact bone health clinically. Surgeons treating intraarticular and extraarticular distal humerus fractures should seriously consider two precontoured, long, thick, locked, and parallel plates that are secured by long, thick, and plate‐to‐plate screws that are located at staggered levels along the proximal parts of the plates, as well as an extra transfracture plate screw. Also, research engineers could improve new studies by perusing recommendations in future work (e.g., studying alternative nonmetallic materials or “stress shielding”), clinical ramifications (e.g., benefits of locked plates), and study quality (e.g., experimental validation of computational studies).

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Section: Resultsmentioning

confidence: 99%

Biomechanical Design Optimization of Distal Humerus Fracture Plates: A Review

Zdero,

Brzozowski,

Schemitsch

2024

BioMed Research International

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“…Screw head unlocking due to inadequately seated locking screws has been previously reported as one of the complications in LCP repair. [12][13][14] The studies of Gallagher and colleagues 18 and Kääb and colleagues 22 demonstrate that off-axis insertion of locking screws with cross-threading significantly compromises mechanical stability to the locking plate-screw interface. Therefore, it is recommended to adequately insert and tighten locking screws to help maintain construct stiffness and to prevent locking screw unlocking.…”

Section: Discussionmentioning

confidence: 99%

“…However, increasing incidence of screw failure in LCP systems was seen by the authors, and previous biomechanical studies reported relatively more screw failure scenarios when LCP constructs were tested under torsion. [12][13][14][15] The purpose of this study was to compare the biomechanical behavior of LCP constructs of three manufacturers, including DPS, KB, and Vi, during fatigue testing in torsion until failure. We hypothesized that the constructs of DPS, KB, and Vi would have no significant difference in torsional stiffness and cycles to failure.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Comparison of Three Locking Compression Plate Constructs from Three Manufacturers under Cyclic Torsional Loading in a Fracture Gap Model

Lai,

James,

Appleyard

et al. 2024

Vet Comp Orthop Traumatol

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Objective The aim of the study was to compare the stiffness and cyclic fatigue of locking compression plate constructs from three manufacturers, DePuy Synthes (DPS), Knight Benedikt (KB), and Provet Veterinary Instrumentation (Vi), under cyclic torsion. Methods The constructs of DPS, KB, and Vi were assembled by fixing a 10-hole 3.5-mm stainless steel locking compression plate 1 mm away from a validated bone model with a fracture gap of 47 mm. The corresponding drill guides and locking screws were used. Three groups of six constructs were tested in cyclic torsion until failure. Results There was no significant difference in initial stiffness between DPS constructs (28.83 ± 0.84 N·m/rad) and KB constructs (28.38 ± 0.81 N·m/rad), and between KB constructs and Vi constructs (27.48 ± 0.37 N·m/rad), but the DPS constructs were significantly stiffer than the Vi constructs. The DPS constructs sustained the significantly highest number of cycles (24,833 ± 2,317 cycles) compared with KB constructs (16,167 ± 1,472 cycles) and Vi constructs (19,833 ± 4,792 cycles), but the difference between KB and Vi constructs was not significant. All constructs failed by screw damage at the shaft between the plate and the bone model. Conclusion DPS constructs showed superior initial torsional stiffness and cyclic fatigue life than Vi constructs, whereas KB and Vi constructs shared comparable results. Further investigation is required to assess the clinical significance of these biomechanical differences.

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Comparison of 3.5 locking compression plate fixation to 3.5 limited contact dynamic compression plate fixation

Cited by 2 publications

References 0 publications

Biomechanical Design Optimization of Distal Humerus Fracture Plates: A Review

Biomechanical Design Optimization of Distal Humerus Fracture Plates: A Review

Biomechanical Comparison of Three Locking Compression Plate Constructs from Three Manufacturers under Cyclic Torsional Loading in a Fracture Gap Model

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