Dynamic Condylar Screw (DCS) versus Condylar Blade Plate (CBP) in Complex Supracondylar Femoral Fractures – A Biomechanical Study

Clinical and Experimental Biomechanical Studies Regarding Innovative Implants in Traumatology

“…In a biomechanical study from 2009, the authors compared the mechanical rigidity of the bone/implant (DCS or CBP) construct in complex supracondylar femoral fractures [5,6].…”

“…">DCS versus CBP in complex supracondylar femoral fractures: a biomechanical studyDistal femoral fractures represent a challenge for orthopedic surgeons, and despite numerous biomechanical studies, the optimal implant is still controversial [1][2][3][4]. However, while plates with angular stability and retrograde interlocking nails are nowadays the best choice for treatment, CBP and DCS were the most used implants until the development of these innovative implants [5].In a biomechanical study from 2009, the authors compared the mechanical rigidity of the bone/implant (DCS or CBP) construct in complex supracondylar femoral fractures [5,6].Twelve synthetic composite femoral bones were fixed in the distal part with six DCS and six CBP, and then, the authors performed by osteotomy a bone defect of 1.5 cm to simulate a complex supracondylar fracture type A3/AO (Figure 1).The femurs were sectioned in the midshaft, and the proximal part of the distal fragments was fixed in a metallic adapter sleeve. The bone-implant constructs were tested for seven types of loading: (1) internal compression; (2) external compression; (3) anterior compression; (4) posterior compression; (5) axial compression; (6) external torsion; and (7) internal torsion.The compression tests were realized up to 350 N, and the applied torsion attended 25 Nm.…”

Minimally Invasive Plate Osteosynthesis (MIPO) in Long Bone Fractures – Biomechanics – Design – Clinical Results

“…Open reduction and internal fixation -ORIF (early principles of the "Arbeitgemeinschaft für Osteosynthesefragen" -AO) through a standard lateral approach was associated with large dissections, ligature of the perforating arteries and fragment devitalization, followed by a high incidence of infections, nonunions, iterative fractures and a need for bone grafting (Schatzker et al, 1979;Sirbu, 2007). The idea of splinting with intramedullary implants in diaphyseal fractures of femur and tibia and the associated biological response despite non-anatomical reduction prompted the usage of plates in a similar manner and the concept of biological plate osteosynthesis have radically improved the treatment of complex meta-and epiphyseal fractures .…”

“…www.intechopen.com A major problem of the minimally invasive surgical techniques is that the classic implants (CBP, CBtP and DCS) are not specially conceived for the percutaneous implantation, and so the procedures are demanding (Krettek et al, 1997b;Sirbu, 2007;Sirbu et al, 2008). On the other side, Frigg (Frigg et al, 2001a(Frigg et al, , 2001b have emphasized three problems during internal fixation with classic plates and screws: primary displacement of the fragments, secondary displacement and periosteal compression that determine the reduction of the blood flow ( fig.…”

“…LISS-DF system is formed by a titanium plate with an anatomical contour with round threaded holes in which the threaded head of the monocortical self-taping selfdrilling screws are locked. Even if it does not participate to axis reestablishment due to multiple fixed angle screws, the LISS system behaves like an internal fixator (Sirbu, 2007;Sirbu et al, 2008;Frigg et al, 2001aFrigg et al, , 2001b. While in classic plates (Fig.…”