Superior versus Anteroinferior Plating of the Clavicle Revisited: A Mechanical Study

Partal, George; Meyers, Kathleen N.; Sama, Nicholas; Pagenkopf, Eric; Lewis, Paul B.; Goldman, Ariel; Wright, Timothy M.; Helfet, David L.

doi:10.1097/bot.0b013e3181c3f6d4

Cited by 71 publications

(54 citation statements)

References 17 publications

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“…With regard to axial compression and torsional stiffness, in previous studies, the application of a locking reconstruction plate resulted in values similar to those in our setup [8][9][10]. Partal et al, for example, used six hole locked reconstruction plates in the superior position and reached an average of 804 N/mm for axial compression, 440 Nmm/ deg for external and 430 Nmm/deg for internal rotation [9] (compare Fig.…”

Section: Discussionsupporting

confidence: 84%

“…As suggested in a previous publication, we tested for torsional and axial compression as well as bending [9]. In our opinion, bending tests are essential, since weights lifted by the abducted arm lead to a multiplication of forces according to the laws of leverage at the fracture site [14], which is well simulated by the three-point bending test and has been established in previous work [8,10].…”

Section: Discussionmentioning

confidence: 97%

“…Partal et al, for example, used six hole locked reconstruction plates in the superior position and reached an average of 804 N/mm for axial compression, 440 Nmm/ deg for external and 430 Nmm/deg for internal rotation [9] (compare Fig. 5).…”

Section: Discussionmentioning

confidence: 99%

“…Twenty cycles of axial compression were applied with a maximum load of 100 N. Afterwards, each clavicle was subjected to 20 cycles of torsion (angular displacement −10°to 10°) at a frequency of 0.25 Hz. Internal rotation was defined as a rotation of the lateral end in anterior, external rotation in the posterior direction to the medial end [9]. The specimens were then dismounted and transferred to the three-point bending test frame (Fig.…”

Section: Biomechanical Testingmentioning

confidence: 99%

“…Subsequently, no further failures have been observed and we have had very good clinical results [7]. Looking at previous biomechanical studies, the main focus was on the difference between locking versus non-locking plates and superior versus anterior-inferior plate position [8][9][10]. To our knowledge, only one study has been published comparing a precontoured plate with regular plates.…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical comparison of the Locking Compression superior anterior clavicle plate with seven and ten hole reconstruction plates in midshaft clavicle fracture stabilisation

Eden

Hoelscher-Doht

Frey

et al. 2012

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to characterise the biomechanical properties of the seven hole superior anterior clavicle LCP (locking compression plate) and to compare these with the properties of commonly applied implants used for the stabilisation of clavicular midshaft fractures such as the locking 7-and ten hole reconstruction plate. Methods Twenty-four synthetic clavicles were used. A transverse midshaft fracture was induced. The clavicles were fixed with angle stable clavicle LCPs, seven hole and ten hole reconstruction plates (n08 each). Twenty cycles of axial compression and torsion were performed for each sample, which was followed by 1,000 cycles of three point bending and ultimately bending to failure. Axial, torsional and cantilever bending stiffness were calculated from the data recorded. Results The clavicle LCP showed the highest overall stiffness compared to the seven and ten hole reconstruction plate. Significantly higher stiffness values were found for axial compression and external rotation. In the load-to-failure tests, the ten hole reconstruction plate especially showed early signs of plastic deformation, which might account for early plate insufficiency so frequently observed clinically. Conclusion The results indicate that the clavicle LCP, as compared to the reconstruction plates, leads to superior biomechanical stability in the treatment of midshaft clavicle fractures.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Biomechanical Testingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Biomechanical comparison of the Locking Compression superior anterior clavicle plate with seven and ten hole reconstruction plates in midshaft clavicle fracture stabilisation

Eden

Hoelscher-Doht

Frey

et al. 2012

International Orthopaedics (SICOT)

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The anatomy of the clavicle

et al. 2013

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The clavicle has a complex osteologic structure that makes morphological analysis extremely difficult. A three-dimensional study was conducted to examine the anatomical variations and characteristics of the bone. Sixty-eight human cadaver clavicles were dissected, CAT-scanned, and reconstructed. An automated parameterization and correspondence shape analysis system was developed. A new length, designated as centerline (CL) length, was defined and measured. This length represents the true length of the clavicle. The endpoint length was measured as the distance between two endpoints. The width and curvature were measured in the axial (AX) and frontal (FR) plane and defined along the CL. Next gender and side characteristics and variations were examined. The mean CL length was 159.0 ± 11.0 mm. The mean endpoint length was 149.4 ± 10.3 mm, which was statistically significantly shorter than the CL. The male clavicle was significantly longer (166.8 ± 7.3 mm vs. 151.0 ± 8.2 mm), wider (14.6 ± 1.5 mm vs. 12.7 ± 1.3 mm lateral FR plane, 25.9 ± 4.1 mm vs. 23.5 ± 3.0 mm lateral AX plane and 24.7 ± 2.8 mm vs. 22.8 ± 2.8 mm medial AX plane), and more curved (10.8 ± 2.8 mm vs. 8.6 ± 2.3 mm medial and 10.5 ± 3.3 mm vs. 9.1 ± 2.5 mm lateral) than the female one. Left clavicles were significant longer (159.8 ± 10.9 mm vs. 158.0 ± 11.2 mm) than right clavicles. A novel three-dimensional system was developed, used and tested in order to explore the anatomical variations and characteristics of the human clavicle. This information, together with the automated system, can be applied to future clavicle populations and to the design of fixation plates for clavicle fractures.

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Clavicle Fractures (Medial, Midshaft, Lateral)

Boltuch

Levy²

2022

The Resident's Guide to Shoulder and Elbow Surgery

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Superior versus Anteroinferior Plating of the Clavicle Revisited: A Mechanical Study

Cited by 71 publications

References 17 publications

Biomechanical comparison of the Locking Compression superior anterior clavicle plate with seven and ten hole reconstruction plates in midshaft clavicle fracture stabilisation

Biomechanical comparison of the Locking Compression superior anterior clavicle plate with seven and ten hole reconstruction plates in midshaft clavicle fracture stabilisation

The anatomy of the clavicle

Clavicle Fractures (Medial, Midshaft, Lateral)

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