Early Temporary Porosis of Bone Induced by Internal Fixation Implants A Reaction to Necrosis, Not to Stress Protection?

Perren, Stephan M.; Cordey, J.; Rahn, B. A.; Gautier, Emanuel; Schneider, Erich

doi:10.1097/00003086-198807000-00018

Cited by 186 publications

(115 citation statements)

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“…Some studies have reported that bone porosis under plates can be observed during the first few months after operation [2]. Although the porosis is an early and temporary effect, it will cause weakening of the bone.…”

Section: Discussionmentioning

confidence: 99%

“…Although the porosis is an early and temporary effect, it will cause weakening of the bone. Many studies revealed that the possible mechanism of bone porosis under plates is the damage of cortical perfusion [2,3]. Thus, if we can reduce vascular damage at the fracture site using lowercontact plates, we can reduce the porosis and improve fracture healing.…”

Section: Discussionmentioning

confidence: 99%

“…Although the pathogenesis of the osteopaenia beneath plates has not been defined, necrosis induced by vascular damage at the periosteal surface under the plate is thought to be one possible mechanism [1][2][3][4][5]. According to this mechanism, more and more designs of bone plates have been made to reduce the contact area between the plate and the bone.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of interface contact profiles of a new minimum contact locking compression plate and the limited contact dynamic compression plate

Xiong

Zhao

Xing

et al. 2009

International Orthopaedics (SICOT)

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In this study, we investigated whether or not a new minimum contact locking compression plate (MC-LCP) can provide advantages over the limited contact dynamic compression plate (LC-DCP) in the context of interface contact area and force. Six matched pairs of cadaveric bones were used for each of three bone types of the humerus, radius and ulna. For each bone type, one of two bone plates was fixed to either of two matched cadaveric bones at the middle of the diaphysis. The interface contact area and force of the plate fixed to three types of human cadaveric bones were evaluated using Fuji prescale pressure sensitive film. Data were quantitated using computer-assisted image analysis. Results showed that the average force between the MC-LCP and humerus or radius was about half of that of the LC-DCP. And the average force between the MC-LCP and ulna was one third less than that of the LC-DCP. Meanwhile, the interface contact area between the MC-LCP and humerus or radius was also about half of that of the LC-DCP, and the interface contact area between the MC-LCP and ulna was less than one third of that of the LC-DCP. These results indicate that the MC-LCP has lower interface contact area and lower average force than that of the LC-DCP. Thus, the MC-LCP system may be a good alternate to treat forearm diaphyseal fractures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of interface contact profiles of a new minimum contact locking compression plate and the limited contact dynamic compression plate

Xiong

Zhao

Xing

et al. 2009

International Orthopaedics (SICOT)

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“…These concepts aim at maximising the biological reaction of the tissues to enhance fracture healing. However, since the stability of the plate depends upon the axial force of the screws compressing the plate to the bone, interference with the periosteal circulation causes cortical necrosis, which leads to cortical porosis beneath the plate, and this may adversely affect the healing potential of the bone with secondary loss of stability [11,12]. However, with the new generation of plates (point contact fixator and locked plate), the stability of the construct depends upon the rigidity of the plate/screw interface rather than the high frictional forces at the bone/plate interface [6,9].…”

Section: Introductionmentioning

confidence: 99%

Locked plate fixation for femoral shaft fractures

El‐Sayed

Said

Abdelaal

et al. 2001

International Orthopaedics (SICOT)

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Fifteen patients with a mean age of 31 years, who had sustained different types of femoral shaft fracture, were treated by locked plate fixation using standard AO dynamic compression plates (DCP). The fracture was open in five patients and ten had other significant injuries. Thirteen patients were available for follow-up at a mean period of 5 months (range, 3-10 months). All fractures united and the mean time to full weight bearing was 8 weeks. Screw failures, with breakage or bending, occurred in five patients and resulted in loss of alignment of the fracture in one. Nine patients regained a full active range of movement of the knee, two had an extension lag of 10°and two had restricted flexion. The strength of the quadriceps muscle was grade 4 to 5 in ten patients and grade 3 in the remaining three. At the end of the study period ten patients had returned to their normal activities, one used a walking stick and two remained under a rehabilitation programme. Our preliminary results suggest that locked plates may offer a useful alternative technique for the treatment of femoral shaft fractures.Résumé Quinze malades d'âge moyen 31 ans présentant une fracture de la diaphyse fémorale ont été traités par plaque verrouillée utilisant une plaque de compression et des vis avec écrou bloquant. La fracture était ouverte cinq fois et dix malades avaient d'autres blessures associées. Treize malades ont été suivis en moyenne 5 mois. Toutes les fractures ont consolidé avec une reprise d'appui en moyenne à 8 semaines. Cinq fois les vis se sont rompues ou déformées avec, seulement dans un cas, une perte de réduction de la fracture. Neuf malades ont retrouvé une mobilité complète du genou. La force du quadriceps était cotée quatre ou cinq chez dix malades. Nos résultats préliminaires suggèrent que les plaques verouillées offrent une technique alternative utile pour le traitement des fractures de la diaphyse fémorale.

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“…9 Under the principle of fracture fixation with the use of DCP plates, designed by the AO Foundation, each eccentric screw causes displacement of 1mm in the fragment fixed to it, thus determining a compression value, 6 which will decrease over five to nine weeks. 5,10,11 During macroscopic analysis of the implants and instruments used in this study, we did not observe alterations in the morphology (size, thickness, hole diameter and slope gradient) of the plates, but the eccentric guides appeared with many differences in this aspect.…”

mentioning

confidence: 99%

Estudo da força de tração utilizando parafuso excêntrico em Placa de Compressão Dinâmica Larga (DCP-L)

Martins¹,

Silva²,

Arnaud³

et al. 2011

Acta ortop. bras.

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OBJETIVO: Avaliar comparativamente a força de tração (F) determinada com a utilização de parafuso excêntrico em placas do tipo compressão dinâmica larga (DCP-L). MÉTODOS: Foram utilizadas três placas de tipo DCP-L de quatro fabricantes nacionais, todas em aço inoxidável austenítico ASTM F 138, e instrumentais disponíveis nas caixas de 4.5mm. As placas foram fixadas a dois corpos de prova sintéticos de polietileno e a força de tração foi obtida pela utilização de parafuso de 4.5mm, introduzido em furo excêntrico, realizado com instrumentais específicos de cada fabricante. Os resultados foram obtidos por uma máquina servo-hidráulica BME 2000 160/AT, Brasválvula. Os implantes foram divididos em grupos. (Fab. I, II, III, IV). Os testes foram interrompidos após atingir uma força de aperto do parafuso excêntrico de 5 N. RESULTADOS: O grupo I apresentou média de Força máxima (F Max.) 80.58 N; grupo II: F Max. 81.63 N; Grupo III: F Max. 36.32N; Grupo IV: F Max. 37.52N. Utilizando a Análise de Variância de Krukal-Wallis (ANOVA não paramétrica), sendo p= 0,05 existe diferença significativa na força máxima entre os grupos (p = 0,039). CONCLUSÃO: As placas DCP-L do grupo II apresentaram maior força (N) com fixação da placa utilizando parafuso excêntrico. Nível de Evidência: Nível III, estudo analítico.

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Early Temporary Porosis of Bone Induced by Internal Fixation Implants A Reaction to Necrosis, Not to Stress Protection?

Cited by 186 publications

References 0 publications

Comparison of interface contact profiles of a new minimum contact locking compression plate and the limited contact dynamic compression plate

Comparison of interface contact profiles of a new minimum contact locking compression plate and the limited contact dynamic compression plate

Locked plate fixation for femoral shaft fractures

Estudo da força de tração utilizando parafuso excêntrico em Placa de Compressão Dinâmica Larga (DCP-L)

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