Does a polyaxial-locking system confer benefits for osteosynthesis of the distal fibula: A cadaver study

Hallbauer, Jakob; Klos, Kajetan; Gräfenstein, A.; Simons, Paul; Rausch, Sascha; Mückley, Thomas; Hofmann, Gunther O.

doi:10.1016/j.otsr.2016.03.014

Cited by 12 publications

(6 citation statements)

References 26 publications

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“…6 In human, medicine biomechanical and clinical studies show good results with the use of PLS. [7][8][9][10] For the veterinary PLS, no study so far has evaluated the differences in stability of screws placed in monoaxial compared with polyaxial fashion.…”

Section: Introductionmentioning

confidence: 99%

Mechanical Performance of a Polyaxial Locking Plate and the Influence of Screw Angulation in a Fracture Gap Model

Kaczmarek¹,

Bartkowiak

Schuenemann³

et al. 2019

Vet Comp Orthop Traumatol

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Objective The aim of this study was to compare the locking compression plate (LCP) with polyaxial locking system (PLS) using single cycle to failure 4-point bending test and to investigate the behaviour of PLS with screws inserted mono- and polyaxially using cyclic fatigue test in two bending directions. Materials and Methods Tests were performed on bone surrogates in a fracture gap model. The 3.5 LCP and 3.5 PLS plates were tested in single cycle to failure. The 3.5 PLS plates with mono- and polyaxial screws were compared in a cyclic fatigue tests in two orthogonal directions. For both experiments, micro-computed tomography (CT) scans were performed pre- and post-testing to investigate the connections between the screw head and the plate hole. Means of forces and cycles needed to failure were statistically compared. Results The PLS plates were on average 30% weaker than LCP plates. Mode of failure was plate bending in the single cycle to failure tests, and plate breakage in the cyclic fatigue tests. Neither screw breakage nor loss of the screw–plate interface occurred. Mono- and polyaxial constructs performed similarly when loaded in the same direction. Micro-CT revealed no additional internal cracks in the plates or screws after testing. It also showed for both PLS and LCP that there was only partial contact of the screw head with the plate hole. Clinical Relevance PLS offers a durable locking system, even when the screws are placed polyaxially. The weaker bending properties of the PLS compared with LCP should be considered during preoperative planning.

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Section: Introductionmentioning

confidence: 99%

Mechanical Performance of a Polyaxial Locking Plate and the Influence of Screw Angulation in a Fracture Gap Model

Kaczmarek¹,

Bartkowiak

Schuenemann³

et al. 2019

Vet Comp Orthop Traumatol

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“…17 -Canny edge detection-an algorithm that allows detection of a wide range of edges in images. 18 -Bresenham's line algorithm-an algorithm that determines the points of a grid that should be selected to form a close approximation to a straight line between two points. It is used to draw line primitives in a bitmap image.…”

Section: Glossarymentioning

confidence: 99%

How Do the Locking Screws Lock? A Micro-CT Study of 3.5-mm Locking Screw Mechanism

Kaczmarek¹,

Bartkowiak

Paczos

et al. 2020

Vet Comp Orthop Traumatol

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Objective To quantify the amount of the screw head thread and the plate hole thread connection in two 3.5 mm locking plates: Locking Compression Plate (LCP) and Polyaxial Locking System (PLS). Materials and Methods A micro - CT scan of a screw head - plate hole connection was performed pre- and post destructive tests. Tests were performed on bone surrogates in a fracture gap model. The 3.5 LCP and 3.5 PLS plates, with 3 perpendicular screws per segment were used in a destructive static test. The 3.5 PLS plates with mono- and polyaxial screws were compared in a cyclic fatigue tests in two orthogonal directions. Pre - and post - test scan datasets were compared. Each dataset was converted into serial images depicting sections cut orthogonally to locking screw axis. The amount of engagement was detected through automated image postprocessing. Results The mean amount of the thread connection for the LCP was 28.85% before and 18.55% after destructive static test. The mean amount of the connection for the PLS was 16.20% before and 14.55% after destructive static test. When inserted monoaxially, the mean amount of the connection for the PLS screws was 14.4% before and 19.24% after destructive cyclic test. The mean amount of the connection for the polyaxial inserted PLS screws when loaded against plate thickness was 2.99% before and 2.08% after destructive cyclic test. The mean amount of the connection for the polyaxial inserted PLS screws when loaded against plate width was 3.36% before and 3.93% after destructive cyclic test. The 3D visualization of the thread connection showed that the initial interface points between screw head and plate hole are different for both LCP and PLS after the destructive testing. Depending on the type of applied force, there was either loss or increase of the contact. Clinical Relevance Micro-CT offers news possibilities in locking implant investigation. It might be helpful in better understanding the nature of locking mechanism and prediction of possible mode of failure in different systems.

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“…Also, in posterior plate placement, there is an opportunity for putting a compression screw across the fracture site in the oblique fracture pattern, making a more stable construct [1]. However, there is no difference in biomechanical properties between the poly-axial locking plate and the non-locking plate in anti-glide plate placement [17].…”

Section: Anti-glide/posterior Platingmentioning

confidence: 99%

Osteoporotic Distal Fibula Fractures in the Elderly: How To Fix Them

Sain

Garg

et al. 2020

Cureus

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Does a polyaxial-locking system confer benefits for osteosynthesis of the distal fibula: A cadaver study

Abstract: Information on the behavior of polyaxial-locking plates is relevant to surgeons performing internal fixation of distal fibula fractures.

Cited by 12 publications

References 26 publications

Mechanical Performance of a Polyaxial Locking Plate and the Influence of Screw Angulation in a Fracture Gap Model

Mechanical Performance of a Polyaxial Locking Plate and the Influence of Screw Angulation in a Fracture Gap Model

How Do the Locking Screws Lock? A Micro-CT Study of 3.5-mm Locking Screw Mechanism

Osteoporotic Distal Fibula Fractures in the Elderly: How To Fix Them

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