Article

A Biomechanical Comparison of One-Third Tubular Plates Versus Periarticular Plates for Fixation of Osteoporotic Distal Fibula Fractures

Saint Louis University Department of Orthopaedic Surgery, St. Louis, MO 63110.
Journal of orthopaedic trauma (Impact Factor: 1.54). 12/2012; 27(9). DOI: 10.1097/BOT.0b013e318281a565
Source: PubMed

ABSTRACT OBJECTIVES:: The purpose of this study was to test the biomechanical properties of locking and non-locking plates, using one-third tubular and periarticular plate designs in an osteoporotic distal fibula fracture model. METHODS:: Twenty four cadaveric specimens, whose bone mineral densities (BMD) were obtained using dual x-ray absorptiometry (DEXA) scans, were tested. The fracture model simulated an OTA 44-B2.1 fracture. The constructs included: 1. Non-locking one-third tubular plate (NTT); 2. Locking one-third tubular plate (LTT); 3. Non-locking periarticular plate (NPA); and 4. Locking periarticular plate (LPA). The specimens underwent axial loading followed by torsional loading to failure. Statistical analysis was performed using Kruskal-Wallis testing, and further analysis with Mann-Whitney testing. RESULTS:: The periarticular plates had greater rotational stiffness compared to the one-third tubular plates (p=0.04). The non-locking plates had greater torque to failure than the locking plates (p=0.01). The NTT had greater torque to failure than the LTT (p=0.03). No significant differences were found in any of the comparisons regarding axial stiffness. CONCLUSIONS:: In biomechanical testing using an osteoporotic model of OTA 44-B2.1 fractures, periarticular plates were superior to one-third tubular plates in rotational stiffness only. Locking plates did not outperform their non-locking counterparts. Periarticular plates should be considered when treating osteoporotic distal fibula fractures, but one-third tubular plates and non-locking plates provide adequate fixation for these injuries.

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