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Biomechanical testing of the locking compression plate: When does the distance between bone and implant significantly reduce construct stability?

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Biomechanical testing of the locking compression plate: When does the distance between bone and implant significantly reduce construct stability? / Ahmad, M.; Nanda, R.; Bajwa, A.S. et al.

In: Injury, Vol. 38, No. 3, 03.2007, p. 358-364.

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Ahmad M, Nanda R, Bajwa AS, Candal-Couto J, Green S, Hui AC. Biomechanical testing of the locking compression plate: When does the distance between bone and implant significantly reduce construct stability? Injury. 2007 Mar;38(3):358-364. doi: 10.1016/j.injury.2006.08.058

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@article{47d51bb7a507492ca863eb2b525b0da5,
title = "Biomechanical testing of the locking compression plate: When does the distance between bone and implant significantly reduce construct stability?",
abstract = "AimTo investigate in vitro the mechanical stability of a locking compression plate (LCP) construct in a simulated diaphyseal fracture of the humerus at increasing distances between the plate and bone.Materials and methodA series of biomechanical in vitro experiments were performed using composite humerus sawbone as the bone model. Osteotomy created in the mid-diaphyseal region. A 10mm osteotomy gap was bridged with a seven-hole 4.5 stainless steel plate with one of four methods: a control group consisted of a dynamic compression plate applied flush to the bone and three study groups which comprised of a LCP applied flush to the bone, at 2mm and at 5mm from the bone. Standard AO technique used with locking head screws used for LCP fixation.Static and dynamic loading tests performed in a custom made jig in which the bone model was fixed both proximally and distally. Samples were subjected to cyclical compression, compression load to failure, cyclical torque and torque to failure.Plastic deformation and failure was assessed using three-dimensional measurements. Scanning electron microscopy of the plate and screw surface allowed detailed inspection of micro-fracture in areas of fatigue.ResultsComparable results were achieved in both the DCP and LCP constructs in which the plate was applied at or less than 2mm from the bone. When applied 5mm from the bone the LCP demonstrated significantly increased plastic deformation during cyclical compression and required lower loads to induce construct failure.Conclusion•At a distance 5mm we observe an inferior performance in the mechanical properties of the LCP construct with decrease in axial stiffness and torsional rigidity.•If it is desirable for an LCP to be used the distance between plate and bone should be ≤2mm.",
keywords = "Locking compression plates, Biomechanical testing, Construct stability",
author = "M. Ahmad and R. Nanda and A.S. Bajwa and J. Candal-Couto and S. Green and A.C. Hui",
year = "2007",
month = mar,
doi = "10.1016/j.injury.2006.08.058",
language = "English",
volume = "38",
pages = "358--364",
journal = "Injury",
issn = "0020-1383",
publisher = "Elsevier Limited",
number = "3",

}

RIS

TY - JOUR

T1 - Biomechanical testing of the locking compression plate: When does the distance between bone and implant significantly reduce construct stability?

AU - Ahmad, M.

AU - Nanda, R.

AU - Bajwa, A.S.

AU - Candal-Couto, J.

AU - Green, S.

AU - Hui, A.C.

PY - 2007/3

Y1 - 2007/3

N2 - AimTo investigate in vitro the mechanical stability of a locking compression plate (LCP) construct in a simulated diaphyseal fracture of the humerus at increasing distances between the plate and bone.Materials and methodA series of biomechanical in vitro experiments were performed using composite humerus sawbone as the bone model. Osteotomy created in the mid-diaphyseal region. A 10mm osteotomy gap was bridged with a seven-hole 4.5 stainless steel plate with one of four methods: a control group consisted of a dynamic compression plate applied flush to the bone and three study groups which comprised of a LCP applied flush to the bone, at 2mm and at 5mm from the bone. Standard AO technique used with locking head screws used for LCP fixation.Static and dynamic loading tests performed in a custom made jig in which the bone model was fixed both proximally and distally. Samples were subjected to cyclical compression, compression load to failure, cyclical torque and torque to failure.Plastic deformation and failure was assessed using three-dimensional measurements. Scanning electron microscopy of the plate and screw surface allowed detailed inspection of micro-fracture in areas of fatigue.ResultsComparable results were achieved in both the DCP and LCP constructs in which the plate was applied at or less than 2mm from the bone. When applied 5mm from the bone the LCP demonstrated significantly increased plastic deformation during cyclical compression and required lower loads to induce construct failure.Conclusion•At a distance 5mm we observe an inferior performance in the mechanical properties of the LCP construct with decrease in axial stiffness and torsional rigidity.•If it is desirable for an LCP to be used the distance between plate and bone should be ≤2mm.

AB - AimTo investigate in vitro the mechanical stability of a locking compression plate (LCP) construct in a simulated diaphyseal fracture of the humerus at increasing distances between the plate and bone.Materials and methodA series of biomechanical in vitro experiments were performed using composite humerus sawbone as the bone model. Osteotomy created in the mid-diaphyseal region. A 10mm osteotomy gap was bridged with a seven-hole 4.5 stainless steel plate with one of four methods: a control group consisted of a dynamic compression plate applied flush to the bone and three study groups which comprised of a LCP applied flush to the bone, at 2mm and at 5mm from the bone. Standard AO technique used with locking head screws used for LCP fixation.Static and dynamic loading tests performed in a custom made jig in which the bone model was fixed both proximally and distally. Samples were subjected to cyclical compression, compression load to failure, cyclical torque and torque to failure.Plastic deformation and failure was assessed using three-dimensional measurements. Scanning electron microscopy of the plate and screw surface allowed detailed inspection of micro-fracture in areas of fatigue.ResultsComparable results were achieved in both the DCP and LCP constructs in which the plate was applied at or less than 2mm from the bone. When applied 5mm from the bone the LCP demonstrated significantly increased plastic deformation during cyclical compression and required lower loads to induce construct failure.Conclusion•At a distance 5mm we observe an inferior performance in the mechanical properties of the LCP construct with decrease in axial stiffness and torsional rigidity.•If it is desirable for an LCP to be used the distance between plate and bone should be ≤2mm.

KW - Locking compression plates

KW - Biomechanical testing

KW - Construct stability

U2 - 10.1016/j.injury.2006.08.058

DO - 10.1016/j.injury.2006.08.058

M3 - Journal article

VL - 38

SP - 358

EP - 364

JO - Injury

JF - Injury

SN - 0020-1383

IS - 3

ER -