scholarly journals Static and dynamic examination of a locking plate in various setups for the stabilization of bone shaft fractures, including periprosthetic

2021 ◽  
Vol 24 (3) ◽  
Author(s):  
Wojciech Marczyński ◽  
Andrzej Sobolewski
Keyword(s):  
Locking Plate ◽  
Plate Fixation ◽  
Cartilage Damage ◽  
Optimal Solution ◽  
Bone Union ◽  
Cable System ◽  
Hip And Knee Arthroplasty ◽  
Dynamic Examination ◽  
The Difference ◽  
Fracture Compression

Introduction: Hip and knee arthroplasty, formerly known as the “gold standard” in the treatment of articular cartilage damage, after a period of being highly popular, are changing the way they are perceived over time due to their related complications. The number of complications is directly proportional to the number of prostheses placed. This is the case of numerus arthroplasty surgeries, also involving other joints. Since there is no tissue compatibility between the metal prosthesis and the bone tissue, the former represents a negative biological element that hinders the healing of the fracture. Objective of the study: The study aims at addressing the following questions: 1. What is the elasticity of the fixation with a locking plate depending on the number of screws in both fragments, in the case of interfractural diastasis?, 2. What is the elasticity of the fixation with a locking plate depending on the number of screws in both fragments, in the case of fracture-on-fracture compression? 3. What is the difference in elasticity of the fixation using the cable system on a fracture with prosthesis?, 4. Determining the influence of different stabilization setups with the locking plate screws on the spacing of the fracture on the static and dynamic experimental model, 5. Is it possible to achieve elasticity of the stabilization stimulating bone union in a plate-based fixation, and when? Material and methods: The study was performed in the research laboratory of ChM. The subject of the study was the ChM 5.0 ChLP straight narrow compression locking plate with limited contact L-238, holes-15. The plate was mounted using ChM 3.5 locking screws: 5.0 ChLP 3.5 x 18T self-tapping screw and 5.0 ChLP 3.5 x 36T self-tapping screw. The test was carried out under static and dynamic conditions. Results and Conclusions: 1. The elasticity of the fixation with a locking plate at the interfractural diastasis is inversely proportional to the number of screws (plate deflection), 2. The elasticity of the fixation with a locking plate at the fracture-on-fracture compression is inversely proportional to the number of screws (fracture-on-fracture compression), 3. Application of the “cable system” on the fracture with prosthesis and the derotation screw optimizes the elasticity of the fixation and seems to be an optimal solution (in periprosthetic fractures), 4. Studies on the experimental static and dynamic model demonstrated that placing screws in all the openings of the plate is a restrained/clinically useless fixation. 5. The elasticity of the stabilization stimulating bone union can be obtained in the plate fixation supported by the "cable system".

scholarly journals A novel surgical approach and technique and short-term clinical efficacy for the treatment of proximal humerus fractures with the combined use of medial anatomical locking plate fixation and minimally invasive lateral locking plate fixation

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Fu Wang ◽  
Yan Wang ◽  
Jinye Dong ◽  
Yu He ◽  
Lianxin Li ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Surgical Approach ◽  
Shoulder Joint ◽  
Locking Plate ◽  
Proximal Humerus ◽  
Plate Fixation ◽  
Anterolateral Approach ◽  
Proximal Humerus Fractures ◽  
Locking Plate Fixation ◽  
Humerus Fractures

Abstract Background and hypothesis The typical anterolateral approach is widely used to treat proximal humerus fractures with lateral locking fixation. However, lateral fixation cannot completely avoid medial reduction loss and varus deformity especially in the cases of an unstable medial column. We present a novel medial surgical approach and technique together with a minimally invasive lateral locking plate to fix proximal humerus fractures with an unstable medial column. Materials and methods We performed an anatomical study and reported 8 cases of proximal humerus fractures with unstable medial columns treated with plate fixation through a minimally invasive anterolateral approach and medial approach. All surgeries were performed by the same single surgeon. Patients were followed clinically and radiographically at 1, 3, 6, and 12 months postoperatively. Results There was a safe region located at the medial part of the proximal humerus just beneath the articular surface. An anatomical medial locking proximal humerus plate could be placed in the medial column and did not affect the axillary nerve, blood supply of the humeral head, or stability of the shoulder joint. Successful fracture healing was achieved in all 8 cases. The function and range of motion of the shoulder joint were satisfactory 24 months postoperatively, with an average Constant score (CS) of 82.8. No reduction loss (≥ 10° in any direction), screw cutout, nonunion, or deep infection occurred. Conclusions The combined application of medial anatomical locking plate fixation and minimally invasive lateral locking plate fixation is effective in maintaining operative reduction and preventing varus collapse and implant failure in proximal humerus fractures with an unstable medial column.

A systematic review of locking plate fixation of proximal humerus fractures

Injury ◽  
2011 ◽  
Vol 42 (4) ◽  
pp. 408-413 ◽  
Author(s):  
Robert C. Sproul ◽  
Jaicharan J. Iyengar ◽  
Zlatko Devcic ◽  
Brian T. Feeley
Keyword(s):  
Systematic Review ◽  
Locking Plate ◽  
Proximal Humerus ◽  
Plate Fixation ◽  
Proximal Humerus Fractures ◽  
Locking Plate Fixation ◽  
Humerus Fractures

Complications following volar locking plate fixation for distal radial fractures: a systematic review

2013 ◽  
Vol 39 (7) ◽  
pp. 745-754 ◽  
Author(s):  
A. Bentohami ◽  
K. de Burlet ◽  
N. de Korte ◽  
M. P. J. van den Bekerom ◽  
J. C. Goslings ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Locking Plate ◽  
Assessment Tool ◽  
Plate Fixation ◽  
Assessment Tools ◽  
Volar Locking Plate ◽  
Locking Plate Fixation ◽  
Distal Radial Fractures ◽  
Level Of Evidence

The purpose of this systematic review is to assess the prevalence of complications following volar locking plate fixation of distal radial fractures. A computer-based search was carried out using EMBASE and PUBMED/MEDLINE. Only prospective comparative and prospective cohort studies that presented data concerning complications after treatment of distal radial fractures with a volar locking plate in human adults with a minimal follow-up of 6 months were included. Two quality assessment tools were used to assess the methodological quality of the studies (level of evidence rating according to the Oxford Centre of Evidence Based Medicine and the modified version of the Cochrane Bone, Joint and Muscle Trauma Group’s former quality assessment tool). Thirty three studies were eligible for final assessment. Most complications were problems with nerve and tendon function as well as complex regional pain syndrome. With an overall complication rate of 16.5%, most of which were ‘minor’ complications and low rates of nonunion and malunion, volar locking plate fixation can be considered a reasonably safe treatment option for patients with distal radial fractures.

scholarly journals Assessment of Intra-articular Screw Penetration During Radial Head and Olecranon Locking Plate Fixation

Hand ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Ismar Dizdarevic ◽  
Claire M. Eden ◽  
Matthew Bengard ◽  
O. Alton Barron ◽  
Louis W. Catalano ◽  
...  
Keyword(s):  
Radial Head ◽  
Locking Plate ◽  
Plate Fixation ◽  
Locking Plate Fixation ◽  
Screw Penetration

scholarly journals Bone plate fixation ability on the dorsal and lateral sides of a metacarpal shaft transverse fracture

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yung-Cheng Chiu ◽  
Cheng-En Hsu ◽  
Tsung-Yu Ho ◽  
Yen-Nien Ting ◽  
Ming-Tzu Tsai ◽  
...  
Keyword(s):  
Mechanical Strength ◽  
Locking Plate ◽  
Plate Fixation ◽  
Shaft Fracture ◽  
Bone Plate ◽  
Lateral Side ◽  
Lateral Plate ◽  
Fracture Force ◽  
Shaft Fractures ◽  
Metacarpal Shaft

Abstract Background Metacarpal shaft fractures are a common hand trauma. The current surgical fixation options for such fractures include percutaneous Kirschner wire pinning and nonlocking and locking plate fixation. Although bone plate fixation, compared with Kirschner wire pinning, has superior fixation ability, a consensus has not been reached on whether the bone plate is better placed on the dorsal or lateral side. Objective The purpose of this study was to evaluate the fixation of locking and regular bone plates on the dorsal and lateral sides of a metacarpal shaft fracture. Materials and methods Thirty-five artificial metacarpal bones were used in the experiment. Metacarpal shaft fractures were created using a saw blade, which were then treated with four types of fixation as follows: (1) a locking plate with four locking bicortical screws on the dorsal side (LP_D); (2) a locking plate with four locking bicortical screws on the lateral side (LP_L); (3) a regular plate with four regular bicortical screws on the dorsal side (RP_D); (4) a regular plate with four regular bicortical screws on the lateral side (RP_D); and (5) two K-wires (KWs). All specimens were tested through cantilever bending tests on a material testing system. The maximum fracture force and stiffness of the five fixation types were determined based on the force–displacement data. The maximum fracture force and stiffness of the specimens with metacarpal shaft fractures were first analyzed using one-way analysis of variance and Tukey’s test. Results The maximum fracture force results of the five types of metacarpal shaft fracture were as follows: LP_D group (230.1 ± 22.8 N, mean ± SD) ≅ RP_D group (228.2 ± 13.4 N) > KW group (94.0 ± 17.4 N) > LP_L group (59.0 ± 7.9 N) ≅ RP_L group (44.5 ± 3.4 N). In addition, the stiffness results of the five types of metacarpal shaft fracture were as follows: LP_D group (68.7 ± 14.0 N/mm) > RP_D group (54.9 ± 3.2 N/mm) > KW group (20.7 ± 5.8 N/mm) ≅ LP_L group (10.6 ± 1.7 N/mm) ≅ RP_L group (9.4 ± 1.2 N/mm). Conclusion According to our results, the mechanical strength offered by lateral plate fixation of a metacarpal shaft fracture is so low that even KW fixation can offer relatively superior mechanical strength; this is regardless of whether a locking or nonlocking plate is used for lateral plate fixation. Such fixation can reduce the probability of extensor tendon adhesion. Nevertheless, our results indicated that when lateral plate fixation is used for fixating a metacarpal shaft fracture in a clinical setting, whether the mechanical strength offered by such fixation would be strong enough to support bone union remains questionable.

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