Article

In vitro biomechanical comparison of limited contat dynamic compression plate and locking compression plate.

College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
Veterinary and Comparative Orthopaedics and Traumatology (Impact Factor: 1.03). 02/2005; 18(4):220-6.
Source: PubMed

ABSTRACT The locking compression plate (LCP) supports biological osteosynthesis by functioning as an internal fixator, rather than as a full or limited contact bone plate which must be adequately contoured and affixed directly to the bone for stable internal fixation of the fracture. In order to help justify the use of the LCP in our veterinary patients, in vitro biomechanical testing was performed comparing the LCP to the conventional limited contact dynamic compression plate (LC-DCP) in canine femurs. We hypothesized that the LCP construct would be at least as stiff under bending and torsional loads as the LC-DCP. The LCP and LC-DCP were applied over a 20-mm osteotomy gap to contralateroal bones within each pair of 14 femora. Non-destructive four-point bending and torsion, and cyclical testing in torsion were performed. The constructs were then loaded to failure in torsion. In medial-lateral and lateral-medial structural bending, significant differences were not found between the LCP and LC-DCP, however, at the gap, the LCP construct was stiffer than the LC-DCP in lateral-medial bending. Significant differences in behaviour over time were not noted between the plate designs during cyclical testing. When loading the constructs to failure in internal rotation, the LC-DCP failed at a significantly lower twist angle (P = .0024) than the LCP. Based on the similar performance with loading, the locking compression plate is a good alternative implant for unstable diaphyseal femoral fracture repair in dogs.

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    • "interface was independent of bone mineral density (Fig. 15). Aguila et al. (2005) performed a comparison study between the LCP and LC-DCP using canine femurs loaded in four-point bending and torsion or cyclic loading in torsion . On the whole, there were no significant differences in bending between the LCP and LC-DCP. "
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    ABSTRACT: Open reduction and internal fixation of fractures involves the use of metallic implants to support bone reduction. This procedure is often used in situations in which adequate alignment and stability of the bone cannot be achieved using nonsurgical methods such as casting. The locking compression plate is a contemporary implant that allows for both conventional screw placement (using nonlocking screws) and locking screw placement (where screw heads lock into the plate at a predetermined angle). This allows for greater versatility in the application of internal fixation. This article presents a general overview of locking compression plate application along with a review of the locking compression plate literature.
    Journal of surgical orthopaedic advances 02/2008; 17(4):271-81.
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    • "interface was independent of bone mineral density (Fig. 15). Aguila et al. (2005) performed a comparison study between the LCP and LC-DCP using canine femurs loaded in four-point bending and torsion or cyclic loading in torsion . On the whole, there were no significant differences in bending between the LCP and LC-DCP. "
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    ABSTRACT: Metallic implants are often involved in the open reduction and internal fixation of fractures. Open reduction and internal fixation is commonly used in cases of trauma when the bone cannot be healed using external methods such as casting. The locking compression plate combines the conventional screw hole, which uses non-locking screws, with a locking screw hole, which uses locking head screws. This allows for more versatility in the application of the plate. There are many factors which affect the functionality of the plate (e.g., screw placement, screw choice, length of plate, distance from bone, etc.). This paper presents a review of the literature related to the biomechanics of locking compression plates and their use as internal fixators in fracture healing. Furthermore, this paper also addresses the materials used for locking compression plates and their mechanical behavior, parameters that control the overall success, as well as inherent bone quality results.
    Clinical Biomechanics 01/2008; 22(10):1049-62. DOI:10.1016/j.clinbiomech.2007.08.004 · 1.88 Impact Factor
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    • "Precise anatomical contouring of a plate is no longer necessary thanks to these new screws and because the plate does not need to be pressed on to the bone to achieve stability. The basic locked internal fixation technique aims at flexible elastic fixation to initiate spontaneous healing, including its induction of callus formation (Aguila et al., 2005; Ahmad et al., 2007; Ruedi et al., 2007; Schutz and Sudkamp, 2003; Weiss et al., 2008). With reference to the mechanical, biomechanical and clinical results, the new AO LCP with combination holes can be used, depending on the fracture situation, as a compression plate, a locked internal fixator, or as an internal fixation system combining both techniques. "
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    ABSTRACT: This paper presents a review of the literature related to the current concepts of internal plate fixation of fractures. Papers selected for this review were drawn from peer review orthopaedic journals. All selected papers specifically discussed plate and screw used to fracture fixation. PubMed search terms were: plates and screws, DCP, LC-DCP, PC-Fix, LCP, LISS, MIPO, and fracture fixation. We review basic plate and screw function, discuss the design rationale for the new implants. Locked plates and conventional plates rely on completely different mechanical principles to provide fracture fixation and in so doing they provide different biological environments for healing. Locked plates may increasingly be indicated for indirect fracture reduction, diaphyseal/metaphyseal fractures in osteoporotic bone, bridging severely comminuted fractures, and the plating of fractures where anatomical constraints prevent plating on the tension side of the bone. Conventional plates may continue to be the fixation method of choice for periarticular fractures which demand perfect anatomical reduction and to certain types of nonunions which require increased stability for union. Bone plating has been used as a method of fracture management since the late 1800's. Stabilization of the fracture using plate requires contact surfaces between implant and bone. The first metal plate used for fractures fixation (Lane, 1895) indicated initial shortcomings such as corrosion, insufficient strength, malunion or nonunion, or a poor return to function. Danis in 1949 recognized the need for compression between the fracture fragments. He achieved this goal using a plate he called the coapteur, which suppressed interfragmentary motion and increased the stability of the fixation. It led to a mode of healing he called soudure autogène (autogenous welding), a process now known as primary bone healing (Danis, 1949). His revolutionary concept influenced all subsequent plate designs. Dynamic Compression Plate (DCP).
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