Mechanical testing of 3.5 mm locking and non-locking bone plates
ABSTRACT Locking plate technologies are being developed in order to provide the surgeon with advantages over previous bone plate systems (both locking and non-locking). Locking plate systems possess inherent biological advantages in fracture fixation by preserving the periosteal blood supply, serving as internal fixators. It is important to consider the strength of each orthopaedic implant as an important selection criterion while utilizing the reported advantages of locking plate systems to prevent catastrophic fracture failure. Mechanical testing of orthopaedic implants is a common method used to provide a surgeon with insight on mechanical capabilities, as well as to form a standardized method of plate comparison. The purpose of this study was to demonstrate and to quantify observed differences in the bending strength between the LCP (Limited Contact Plate), LC-DCP, 3.5 mm Broad LC-DCP (Limited Contact Dynamic Compression Plate), and SOP (String of Pearls) orthopaedic bone plates. The study design followed the ASTM standard test method for static bending properties of metallic bone plates, which is designed to measure mechanical properties of bone plates subjected to bending, the most common loading encountered in vivo. Single cycle four point bending was performed on each orthopaedic implant. The area moment of inertia, bending stiffness, bending strength, and bending structural stiffness were calculated for each implant. The results of this study demonstrated significant differences (p<0.001) in bending strength and stiffness between the four orthopaedic implants (3.5 Broad LC-DCP>SOP>LCP=LC-DCP). The 3.5 mm LCP should be expected to provide in vivo strength and stiffness similar to a comparable LC-DCP. The SOP should provide strength and stiffness that is greater than a comparable LC-DCP but less than a 3.5 mm Broad LC-DCP.
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ABSTRACT: 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. 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. The elevated Fence constructs allowed significantly higher gap motion compared to the LCP instrumentations (axial compression: p <or= 0.011, torsion p <or= 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 <or= 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. 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.BMC Musculoskeletal Disorders 05/2010; 11:95. DOI:10.1186/1471-2474-11-95 · 1.90 Impact Factor
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ABSTRACT: Objective To determine the incidence of fibular penetration during placement of the Synthes® locking TPLO plate with and without the use of a jig. Study DesignCadaveric, experimental study. Sample PopulationCadaveric paired pelvic limbs (n = 8) from skeletally mature dogs. Methods Limbs were assigned to 1 of 2 groups (jig-less-TPLO = no jig used; jig-TPLO = jig used). Synthes® locking TPLO plates were applied using proximal screws of excessive length to facilitate identification of fibular penetration. Screw tip locations were identified by dissection and frequency of fibular penetration was compared between groups. ResultsNone of the jig-TPLO limbs and 6 (75%) of jig-less-TPLO limbs had fibular penetration, a difference that was statistically significant. Fibular penetration was most frequently associated with the most proximal screw. ConclusionsA significantly higher incidence of fibular penetration occurs when Synthes® locking TPLO is performed without use of a jig.Veterinary Surgery 05/2014; 43(4). DOI:10.1111/j.1532-950X.2014.12152.x · 0.99 Impact Factor
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ABSTRACT: Objective To compare the 3.5 string of pearls (SOP) plate with a 3.5 mm locking compression plate (LCP) using a fracture model in static loading and cyclic fatigue testing.Study DesignIn vitro biomechanical testing of paired tibias with a mid-diaphyseal ostectomy, stabilized by 1 of 2 locking systems.Sample PopulationCadaveric canine tibiae (n = 24 pairs).Methods Tibias were randomly divided into 4 equal groups: (1) 4-point bending single cycle to failure, (2) 4-point bending cyclic fatigue, (3) torsion single cycle to failure, and (4) torsion cyclic fatigue. Randomly assigned SOP and LCP bridged a 20 mm mid-diaphyseal ostectomy. Mean test variables values for each method were compared using a paired t-test within each group with significance set at P < .05.ResultsThe SOP construct had significantly greater mean yield load, mean yield displacement, mean yield bending moment, mean composite rigidity and mean failure bending moment under static 4-point bending to failure than the LCP construct. Mean number of cycles to failure under 4-point bending was significantly greater for the SOP constructs but the mean number of cycles to failure in torsion was significantly greater for the LCP constructs. The LCP construct had significantly greater mean composite stiffness and significantly lesser mean displacement to yield and to failure in static torsion testing.Conclusion The SOP construct was superior under bending static and cycling testing but the LCP construct was superior in static and cycling torsion testing.Veterinary Surgery 04/2014; 43(4). DOI:10.1111/j.1532-950X.2014.12095.x · 0.99 Impact Factor