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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2010

Open Access 01-12-2010 | Research article

Biomechanical investigation of an alternative concept to angular stable plating using conventional fixation hardware

Authors: Markus Windolf, Kajetan Klos, Dirk Wähnert, Bas van der Pol, Roman Radtke, Karsten Schwieger, Roland P Jakob

Published in: BMC Musculoskeletal Disorders | Issue 1/2010

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Abstract

Background

Angle-stable locking plates have improved the surgical management of fractures. However, locking implants are costly and removal can be difficult. The aim of this in vitro study was to evaluate the biomechanical performance of a newly proposed crossed-screw concept ("Fence") utilizing conventional (non-locked) implants in comparison to conventional LC-DCP (limited contact dynamic compression plate) and LCP (locking compression plate) stabilization, in a human cadaveric diaphyseal gap model.

Methods

In eight pairs of human cadaveric femora, one femur per pair was randomly assigned to receive a Fence construct with either elevated or non-elevated plate, while the contralateral femur received either an LCP or LC-DCP instrumentation. Fracture gap motion and fatigue performance under cyclic loading was evaluated successively in axial compression and in torsion. Results were statistically compared in a pairwise setting.

Results

The elevated Fence constructs allowed significantly higher gap motion compared to the LCP instrumentations (axial compression: p ≤ 0.011, torsion p ≤ 0.015) but revealed similar performance under cyclic loading (p = 0.43). The Fence instrumentation with established bone-plate contact revealed larger fracture gap motion under axial compression compared to the conventional LC-DCP osteosynthesis (p ≤ 0.017). However, all contact Fence specimens survived the cyclic test, whereas all LC-DCP constructs failed early during torsion testing (p < 0.001). All failures occurred due to breakage of the screw heads.

Conclusions

Even though accentuated fracture gap motion became obvious, the "Fence" technique is considered an alternative to cost-intensive locking-head devices. The concept can be of interest in cases were angle-stable implants are unavailable and can lead to new strategies in implant design.
Appendix
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Metadata
Title
Biomechanical investigation of an alternative concept to angular stable plating using conventional fixation hardware
Authors
Markus Windolf
Kajetan Klos
Dirk Wähnert
Bas van der Pol
Roman Radtke
Karsten Schwieger
Roland P Jakob
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2010
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-11-95

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