In vitro biomechanical comparison of a plate-rod combination–construct and an interlocking nail–construct for experimentally induced gap fractures in canine tibiae

Pfeil, Dirsko J F von; Déjardin, Loïc M.; DeCamp, Charles E.; Meyer, Eric G.; Lansdowne, Jennifer L.; Weerts, Robin J H; Haut, Roger C.

doi:10.2460/ajvr.2005.66.1536

Cited by 47 publications

(107 citation statements)

References 24 publications

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“…19,20 This load permits relative comparison of strain data within the elastic zone prior to permanent deformation which is in agreement with methodology used in previous strain studies. 3,7,21 Von Mises strain is a combination of all strains at a particular area of interest and therefore does not have a direction.…”

Section: Discussionsupporting

confidence: 68%

“…Pins of smaller diameter than previously recommended have been used in PR constructs to engage sufficient distal cancellous bone and avoid pin interference. 19,20 The finding that a pin of any size significantly increased the load to failure of LCPR constructs over the LCP constructs in this study was interesting. Approximations based on comparing means showed the load to failure of the LCPR20 construct was only 8% greater than that of the LCPMono and only 5% greater than that of the LCPBi.…”

Section: Discussionmentioning

confidence: 71%

“…19 For a successful outcome, a fracture must heal prior to implant failure. However, the vast majority of orthopaedic biomechanical testing focuses on implant characteristics and gives little consideration to biological factors which influence the rate of fracture healing.…”

Section: (B) Application Of Biomechanicsmentioning

confidence: 99%

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The effect of intramedullary pin size and monocortical screw configuration on locking compression plate-rod constructs in an in vitro fracture gap model

Pearson¹,

Glyde²,

Hosgood³

et al. 2015

Vet Comp Orthop Traumatol

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Objective: To investigate the effect of intramedullary (IM) pin size in combination with various monocortical screw configurations on construct stiffness and strength as well as plate stain in locking compression plate-rod (LCPR) constructs. Methods:A synthetic bone model with a 40mm fracture gap was used. LCPs with monocortical locking screws were tested with no pin (LCPMono) and IM pins of 20% (LCPR20), 30% (LCPR30) and 40% (LCPR40) of IM diameter. LCPs with bicortical screws (LCPBi) were also tested in the first paper.The first paper used screw configurations with 2 or 3 screws per fragment modelling long (8 hole), intermediate (6 hole) and short (4 hole) plate working lengths. Responses to axial compression, biplanar four point bending and axial load to failure were recorded. The second paper used 2 screws per fragment to model a long (8 hole) and short (4 hole) plate working length and strain responses to axial compression were recorded at 6 regions of the plate via 3D digital image correlation. Results:In the first paper, LCPBi were not significantly different from LCPMono control for any of the outcome variables measured. In bending, LCPR20 were not significantly different from LCPBi and LCPMono. LCPR30 were stiffer than LCPR20 and the controls. LCPR40 constructs were stiffer than all other constructs. The addition of an IM pin of any size provided a significant increase in axial stiffness and load to failure. This effect was incremental with increasing IM pin diameter. As plate working length decreased there was a significant increase in stiffness across all constructs.The addition of an IM pin of any size provided a significant decrease in plate strain. For the long working length, LCPR30 and LCPR40 had significantly lower strain than the LCPR20 and plate strain was significantly higher adjacent to the screw closest to the fracture site. For the short working length, there was no significant difference in strain across any LCPR constructs or at any region of the plate. Plate strain was significantly lower for the short working length compared to the long working length for LCPMono and LCPR20 but not LCPR30 and LCPR40. Conclusions:A pin of any size increases resistance to axial loads whereas a pin of at least 30% IM diameter is required to increase bending stiffness. Short plate working lengths provide maximum stiffness. However, the overwhelming effect of IM pin size obviates the effect of changing plate working length on construct stiffness.The increase in plate strain encountered with a long working length can be overcome by the use of a pin of 30-40% IM diameter. Where placement of a large diameter IM pin is not possible, screws should be placed as close to the fracture gap as possible to minimize plate strain and distribute it more evenly over the plate.Both studies showed a consistent effect of increasing IM pin diameter and using a short plate working length. However, a significant interaction effect between these variables was only detected on plate strain with the IM pin largely negating...

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 71%

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The effect of intramedullary pin size and monocortical screw configuration on locking compression plate-rod constructs in an in vitro fracture gap model

Pearson¹,

Glyde²,

Hosgood³

et al. 2015

Vet Comp Orthop Traumatol

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show abstract

“…According to Lu, early weight bearing after surgery involving a braid fixation system reduces micro-motions at the fracture site (Lu et al 2009). Micro-motions are caused by instability which is difficult to eliminate in fixation systems that rely on standard interlocking nails (von Pfeil et al 2005, Dejardin et al 2006. The work of Kaspar (Kaspar et al 2005) seems to corroborate the above findings.…”

Section: Discussionmentioning

confidence: 61%

Treatment of comminuted tibial shaft fractures in four dogs with the use of interlocking nail connected with type I external fixator

Piórek¹,

Adamiak²,

Jaskólska³

et al. 2012

Polish Journal of Veterinary Sciences

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The treatment of comminuted tibial shaft fractures in canine patients is burdened by significant risk which involves bone healing complications, such as delayed bone union. Complications may result from iatrogenic damage to blood vessels during fracture stabilization. To minimize this risk, treatment methods increasingly often rely on the concept of biological osteosynthesis. One of such methods involves the treatment of fractures with the use of new hybrid fixator consisted of an interlocking nail connected with type I external fixator. Connection of the nail with external fixator has been recently developed to maximize treatment efficiency. This manner of stabilization increases bone-fixator construct strength on forces acting in the place of fracture. It also enables fracture fixation with minimal damage of the blood supply of bone fragments. This article describes surgical procedure of stabilization of comminuted tibial bone fractures in four dogs by the use of interlocking nail connected with external fixator type I, discusses and evaluates the results of clinical treatment with the involvement of the said fixator. To control bone consolidation process the radiograms were taken in 6 and 8 week of healing.In all cases, the reviewed methods of clinical treatment were successful in producing bone union after eight week of healing. During the whole period of observations no complication was observed. In all cases the intramedullary nail were left in the medullary canal after the healing process was finished. The fixator supported quick restoration of limb function after treatment.

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“…The use of additional plates, bone graft, and vascularized fibulae is more a function of the nature of the disease than the method of fixation [13,25,32]. The decision to augment the reconstruction was based on the size of patient, residual length of host bone, and rotational stability.…”

Section: Discussionmentioning

confidence: 99%

Intercalary Allograft Reconstructions Using a Compressible Intramedullary Nail: A Preliminary Report

Miller

Virkus

2010

Clinical Orthopaedics &Amp; Related Research

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In vitro biomechanical comparison of a plate-rod combination–construct and an interlocking nail–construct for experimentally induced gap fractures in canine tibiae

Cited by 47 publications

References 24 publications

The effect of intramedullary pin size and monocortical screw configuration on locking compression plate-rod constructs in an in vitro fracture gap model

The effect of intramedullary pin size and monocortical screw configuration on locking compression plate-rod constructs in an in vitro fracture gap model

Treatment of comminuted tibial shaft fractures in four dogs with the use of interlocking nail connected with type I external fixator

Intercalary Allograft Reconstructions Using a Compressible Intramedullary Nail: A Preliminary Report

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