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Medial helical versus straight lateral plating of distal femoral fractures—a biomechanical comparative study.
- Source :
-
Clinical Biomechanics . Dec2023, Vol. 110, pN.PAG-N.PAG. 1p. - Publication Year :
- 2023
-
Abstract
- Distal femoral fractures are commonly treated with lateral straight plates. However, the lateral approach may not always be desirable, and 180°-helical plates may be an alternative. To investigate the biomechanical competence of 180°-helical plating versus standard straight lateral plating of unstable fractures at the distal femur. Twelve left artificial femora were instrumented with a 15-hole Locking Compression Plate–Distal Femur, using either 180°-helical plates (group 1) or conventional straight lateral plates (group 2). An unstable distal femoral fracture AO/OTA 33-A3.3 was simulated. All specimens were biomechanically tested under quasi-static and progressively increasing combined cyclic axial and torsional loading in internal rotation until failure. Initial axial stiffness (N/mm) was significantly higher in group 1 (185.6 ± 50.1) compared to group 2 (56.0 ± 14.4), p < 0.001. Group 1 demonstrated significantly higher initial interfragmentary flexion (°) and significantly lower initial varus/valgus deformation (°) under 500 N static axial compression versus group 2 (2.76 ± 1.02 versus 0.87 ± 0.77 and 4.08 ± 1.49 versus 6.60 ± 0.47), p ≤ 0.005. Shear displacement (mm) under 6 Nm static torsion was significantly higher in group 1 versus group 2 in both internal (1.23 ± 0.28 versus 0.40 ± 0.42) and external (1.21 ± 0.40 versus 0.57 ± 0.33) rotation, p ≤ 0.013. Cycles to failure and failure load (N) (clinical/catastrophic) were significantly higher in group 1 (12,484 ± 2116/13,752 ± 1518 and 1748.4 ± 211.6/1875.2 ± 151.8) compared to group 2 (7853 ± 1262/9727 ± 836 and 1285.3 ± 126.2/1472.7 ± 83.6), p ≤ 0.001. Although 180°-helical plating using a pre-contoured standard straight lateral plate was associated with higher shear and flexion movements, it demonstrated improved initial axial stability and resistance against varus/valgus deformation compared to straight lateral plating. Moreover, the helical plates were associated with significantly higher endurance to failure. From a biomechanical perspective, 180°-helical plating may be considered as a valuable alternative to standard straight lateral plating of unstable distal femoral fractures. • 180°- helical plates demonstrate higher shear and flexion movements compared to straight plates. • 180°-helical plates demonstrate improved axial stability and resistance against varus deformation compared to straight plates. • 180°-helical plates demonstrate improved resistance to failure compared to straight plates. • 180°-helical plating may be considered as alternative to straight plating of unstable distal femoral fractures. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 02680033
- Volume :
- 110
- Database :
- Academic Search Index
- Journal :
- Clinical Biomechanics
- Publication Type :
- Academic Journal
- Accession number :
- 173630445
- Full Text :
- https://doi.org/10.1016/j.clinbiomech.2023.106119