Biomechanical Comparison of Double-Row Locking Plates Versus Single- and Double-Row Non-Locking Plates in a Comminuted Metacarpal Fracture Model

Gajendran, Varun K.; Szabo, Robert M.; Myo, George K.; Curtiss, Shane

doi:10.1016/j.jhsa.2009.07.005

Cited by 41 publications

(45 citation statements)

References 45 publications

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“…The tests showed a comparable stability of a monocortical locking screw fixation and a bicortical non-locking screw fixation. Gajendran et al demonstrated advantages of locking double-row plates with an interlocking mechanism by titanium deformation for comminuted metacarpal fractures, as compared to non-locking plates [7]. Also in that study the locking plates were attached only using monocortical screw fixation.…”

Section: Discussionmentioning

confidence: 95%

“…However, taking the high costs of locking implants into account, biomechanical studies for evidence-based guidelines of treatment are needed for their use in hand surgery. Two recent biomechanical studies investigated locking plates with the interlocking mechanism of titan deformation and showed a higher stability with locking monocortical screws compared to non-locking screws [7,8].…”

Section: Introductionmentioning

confidence: 99%

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Higher stability with locking plates in hand surgery? Biomechanical investigation of the TriLock system in a fracture model

Hoelscher-Doht

Jansen

Meffert

et al. 2012

International Orthopaedics (SICOT)

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Purpose The aim of this study was to determine the biomechanical characteristics of locking plates with the TriLock system with different design and screw settings compared to a non-locking plate in a diaphyseal metacarpal fracture. Methods Oblique diaphyseal shaft fractures in porcine metacarpal bones were created in a biomechanical fracture model. After reduction they were fixed with three different locking plates with the TriLock interlocking mechanism or a non-locking linear plate in mono-or bicortical screw fixations. In load to failure tests the maximum load and stiffness were measured. Results For linear plates, the maximum load was higher for the non-locking plate compared with the locking plate. The maximum load could be increased for the locking plates using a double-row design and a higher screw number. No differences were found for the stiffness between all groups. In contrast to the non-locking plate, the mode of failure of the locking plates in many cases (86 %) was a loss of the interlocking mechanism. Conclusions The results suggest that the locking plates with the TriLock system achieve no higher stability compared to a non-locking plate in load to failure tests. Adaptions to increase the stability of the interlocking mechanism are desirable.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Higher stability with locking plates in hand surgery? Biomechanical investigation of the TriLock system in a fracture model

Hoelscher-Doht

Jansen

Meffert

et al. 2012

International Orthopaedics (SICOT)

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“…A smaller study of open or closed fractures of the metacarpals and phalanges showed equally good results using less prominent plates of 0.6 mm compared to 1.3 mm thickness, without any cases of tendon rupture, nonunion, or hardware removal among the 21 metacarpal fractures [15]. Also, biomechanical studies of newer constructs, including locking plates, shorter length plates, double-row plates (sometimes called "cage," "ladder," or "three-dimensional"), and smaller dual orthogonal plates demonstrate equivalent or superior fixation to standard constructs, thus potentially minimizing soft tissue dissection and/or hardware prominence [16][17][18][19].…”

Section: Cortical Screws and Platesmentioning

confidence: 99%

Metacarpal fractures in the athlete

Soong

Chase

Kasparyan

2017

Curr Rev Musculoskelet Med

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Purpose of review To describe current evaluation and treatment of metacarpal fractures in athletes Recent findings Biomechanical and clinical studies involving lower-profile, locking, shorter length, and double-row or separate-dual plate configurations, as well as intramedullary screw fixation, have demonstrated the potential benefits of internal fixation with promising results. Summary Treatment should be customized to the specific athlete and injury, and is often successful without surgery, or with percutaneous pin fixation. Internal fixation of metacarpal fractures has improved with new hardware and new techniques, and may expedite return to play, although further clinical studies are needed.

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“…Vor allem die Wertigkeit der Nutzung im Bereich des Metacarpus ist weitgehend unstrittig. Hingegen steht die Frage nach der Anwendung von Platten im Bereich der Phalangen immer wieder aufgrund der häufigen Probleme mit resultierenden Bewegungseinschränkungen nach der Osteosynthese in der Diskussion [7,16,24].…”

Section: Nichtwinkelstabile Implantateunclassified

“…Werden größere Implantate benötigt, sind diese zur Auswahl meist (bei weitgehend allen Herstellern) auf den Osteosynthese-Racks schon in verschiedenen Stärken vorhanden (Plattenprofilhöhe dann meist um 1,0 mm und Schraubendurchmesser um 1,4/1,7/2,3 mm). Der Werkstoff ist regelmäßig Titan [7,24]. Gerade für Metacarpus und Phalangen ist die dünne Plattenprofilhöhe vorteilhaft, da schon anatomiebedingt wenig Platz vorhanden ist und weniger Weichteiladhärenzen bei schlanken Implantaten zu erwarten sind.…”

Section: Nichtwinkelstabile Implantateunclassified