Choosing a proper working length can improve the lifespan of locked plates

Locking Buttons Increase Fatigue Life of Locking Plates in a Segmental Bone Defect Model

“…In a study of the effect of working length on fatigue life of locking plates, increased working length increased fatigue life of titanium plates but not stainless steel plates [20]. The plates used in this study also were stainless steel, however, testing in that study was performed using peak loads slightly greater than the elastic limit, whereas we used loads that were 65% of the elastic limit.…”

Observe a distância entre a linha de fratura e o comprimento da área de trabalho: análise bidimensional de elementos finitos em modelo de fixação extramedular

“…Assim, quanto maior a capacidade elástica de deformação da placa em ponte, menor seu risco de quebra ou fadiga. 17 Com modelos artificiais de fêmur, Hoffmeier et al 18 e Kanchanomai et al 19 observaram redução na tensão superficial de placas bloqueadas em aço inoxidá-vel e em titânio quanto maior a área de trabalho do implante. Isso mostra que comportamento de fadiga dependente, dentre outros fatores relacionados à técnica de osteossíntese, da área de trabalho.…”

Overlapping intramedullary nailing after failed minimally invasive locked plating for osteoporotic distal femur fractures – Report of 2 cases

“…Therefore, a bicortical or unicortical locking screw should not be used at the proximal outermost hole to avoid a stress riser or insufficient fixation in osteoporotic bone, respectively [7,9,10]. Besides, longer plate should be used as much as possible to increase the plate's working length and to secure sufficient fixation for proximal fragment [11,13].…”

“…4C). This implant failure was caused by insufficient fixation of proximal fragment secondary to the use of short plate and unicortical locking screw in osteoporotic bone [3,11]. We decided to perform overlapping IM nailing with plate and distal screws left in situ.…”