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Archives of Orthopaedic and Trauma Surgery

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01-06-2011 | Basic Science

Locking plates have increased torsional stiffness compared to standard plates in a segmental defect model of clavicle fracture

Authors: Ryan Will, Richard Englund, John Lubahn, Timothy E. Cooney

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 6/2011

Abstract

Objective

To evaluate the effect of locked plate technology to resist torsion in a clavicle fracture model of segmental bone loss.

Methods

Forty-four synthetic clavicles were repaired with either 3.5 mm locked compression plate (LCP) or 3.5 mm low-contact dynamic compression plate (LCDCP). They were divided into two groups of 22 specimens. Each group was tested to evaluate torsional stiffness, load at failure, deflection at failure, and unconstrained plate motion.

Results

LCP group showed significantly greater stiffness in torsion compared to the LCDCP group (p < 0.001). Average difference was 20.9%. Load at failure was not significantly different (p < 0.07). Deflection at failure was significantly less for the LCP group (p < 0.03). Unconstrained motion or plate ‘looseness’ was significantly less for the LCP group (p < 0.017).

Conclusions

In a simulated model of segmental clavicle fracture, a LCP provided more stiffness and less deflection than a low-contact dynamic compression plate.

Nordqvist A, Petersson C (1994) The incidence of fractures of the clavicle. Clin Ortho 300:127–132

McKee MD, Pedersen EM, Jones C et al (2006) Deficits following nonoperative treatment of displaced midshaft clavicular fractures. J Bone Joint Surg Am 88-A(1):35–40CrossRef

Hill JM, McGuire MH, Crosby LA (1997) Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J Bone Joint Surg Br 79:537–539PubMedCrossRef

Nowak J, Holgersson M, Larsson S (2005) Sequelae from clavicular fractures are common. Acta Orthop 76(4):496–502PubMedCrossRef

McKee M, Wild L, Schemitsch E (2003) Midshaft malunions of the clavicle. J Bone Joint Surg Am 85A(5):790–797

Canadian Orthopaedic Trauma Society (2007) Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am 89-A(1):1–10CrossRef

Celestre P, Robertson C, Mahar A et al (2008) Biomechanical evaluation of clavicle fracture plating techniques: does a locking plate provide improved stability. J Orthop Trauma 22(4):241–247PubMedCrossRef

Robertson C, Celestre P, Mahar A, Swartz A (2009) Reconstruction plates for stabilization of mid-shaft clavicle fractures: differences between nonlocked and locked plates in two different positions. J Shoulder Elbow Surg 18:204–209PubMedCrossRef

Iannotti M, Crosby L, Stafford P et al (2002) Effects of plate location, selection on the stability of midshaft clavicle osteotomies: a biomechanical study. J Shoulder Elbow Surg 11:457–462PubMedCrossRef

10.

Heiner AD, Brown TD (2001) Structural properties of a new design of composite replicate femurs, tibias. J Biomech 34:773–781PubMedCrossRef

11.

Cristofolini L, Viceconti M (2000) Mechanical validation of whole bone composite tibia models. J Biomech 33:279–288PubMedCrossRef

12.

Cristofolini L, Viceconti M, Cappello A, Toni A (1996) Mechanical validation of whole bone composite femur models. J Biomech 29(4):525–535PubMedCrossRef

13.

Mazzocca AD, Caputo AE, Browner BD, Mast JW, Mendes MW (2003) Principles of internal fixation in skeletal trauma. In: Browner BD, Jupiter JB, Levine AM, Trafton PG (eds) Skeletal trauma: basic science, management, and reconstruction, 3rd edn. Saunders Philadelphia, PA, p 215

14.

Sahara W, Sugamoto K, Murai M et al (2007) Three-dimensional clavicular and acromioclavicular rotations during arm abduction using vertically open MRI. J Orthop Res 25:1243–1249PubMedCrossRef

15.

Ludewig PM, Behrens SA, Meyer SM et al (2004) Three-dimensional clavicular motion during arm elevation: reliability and descriptive data. J Orthop Sports Phys Ther 34:140–149PubMedCrossRef

16.

Warner JJP (2009) Audio-Digest Orthopaedics 32(2). http://www.cme-ce-summaries.com/orthopaedics/or3202.html

17.

Bowman SM, Zeind J, Gibson LJ et al (1996) The tensile behavior of demineralized bovine cortical bone. J Biomech 29(11):1497–1501PubMedCrossRef

18.

Klos K, Sauer S, Hoffmeier K et al (2009) Biomechanical evaluation of plate osteosynthesis of distal fibula fractures with biodegradable devices. Foot Ankle Int 30(3):243–251PubMedCrossRef

19.

Stoffel K, Dieter U, Stachowiak G, Gachter A, Kuster MS (2003) Biomechanical testing of the LCP–how can stability in locked internal fixators be controlled? Injury 34(Suppl 2):B11–B19PubMedCrossRef

20.

Hipps JA, Hayes WC (2003) Biomechanics of fractures. In: Browner BD, Jupiter JB, Levine AM, Trafton PG (eds) Skeletal trauma: basic science, management, and reconstruction, vol 1, 3rd edn. p 112

21.

Filipowicz D, Lanz O, McLaughlin R et al (2009) A biomechanical comparison of 3.5 locking compression plate fixation to 3.5 limited contact dynamic compression plate fixation in a canine cadaveric distal humeral metaphyseal gap model. Vet Comp Orthop Traumatol 22(4):270–277PubMed

22.

Greiwe RM, Archdeacon MT (2007) Locking plate technology: current concepts. J Knee Surg 20(1):50–55PubMed

23.

Smith WR, Ziran BH, Anglen JO, Stahel PF (2007) Locking plates: tips and tricks. J Bone Joint Surg 89A(10):2298–2307

24.

Bottlang M, Doornink J, Fitzpatrick DC, Madey SM (2009) Far cortical locking can reduce stiffness of locked plating constructs while retaining construct strength. J Bone Joint Surg 91(A):1985–1994PubMedCrossRef

25.

Inman VT, Saunders JB, Abbott LC (1994) Observations of the function of the shoulder joint. J Bone Joint Surg Am 26A:1–30

26.

Yinger K, Scalise J, Olson S et al (2003) Biomechanical comparison of posterior pelvic ring fixation. J Orthop Trauma 17:481–487PubMedCrossRef

27.

Adamczyk MJ, Odell T, Oka R (2007) Biomechanical stability of bioabsorbable screws for fixation of acetabular osteotomies. J Pediatr Orthop 27:314–318PubMedCrossRef

28.

Amander MW, Reeves A, MacLeod IAR et al (2008) A biomechanical comparison of plate configuration in distal humerus fractures. J Orthop Trauma 22(5):332–336CrossRef

29.

Lee SS, Mahar AT, Miesen D et al (2002) Displaced pediatric supracondylar humerus fractures: biomechanical analysis of percutaneous pinning techniques. J Pediatr Orthop 22:440–443PubMedCrossRef

Title: Locking plates have increased torsional stiffness compared to standard plates in a segmental defect model of clavicle fracture
Authors: Ryan Will
Richard Englund
John Lubahn
Timothy E. Cooney
Publication date: 01-06-2011
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 6/2011
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-010-1240-y

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Springer Medicine

Locking plates have increased torsional stiffness compared to standard plates in a segmental defect model of clavicle fracture

Abstract

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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