Comparison of Lateral Locking Plate and Antiglide Plate for Fixation of Distal Fibular Fractures in Osteoporotic Bone: A Biomechanical Study

Minihane, Keith P.; Lee, Chris; Ahn, Chulhyun; Zhang, Liqun; Merk, Bradley R.

doi:10.1097/01.bot.0000245684.96775.82

Cited by 132 publications

(105 citation statements)

References 25 publications

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“…No plates actually failed; this finding is consistent with those of other similar studies. 17,27 One pair of specimens in each group failed bilaterally with transverse fractures distal to the plate. All of the remaining 7 pairs (n = 14) failed with a coronal oriented fracture propagating from the fracture gap distally through the screw holes and then out the anterior cortex of the fibula.…”

Section: Resultsmentioning

confidence: 99%

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Locked plate fixation of the comminuted distal fibula: a biomechanical study

et al. 2013

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RESEARCH • RECHERCHELocked plate fixation of the comminuted distal fibula: a biomechanical study Background: The purpose of this study was to compare the biomechanical properties of locked versus nonlocked lateral fibular bridge plating of comminuted, unstable ankle fractures in a mode of catastrophic failure. Methods:We created comminuted Weber C fractures in 8 paired limbs from fresh cadavers. Fractures were plated with either standard or locked one-third tubular bridge plating techniques. Specimens were biomechanically evaluated by external rotation to failure while subjected to a compressive load approximating body weight. We measured the angle to failure, torque to failure, energy to failure and construct stiffness. Results:There was no significant difference in construct stiffness or other biomechanical properties between locked and standard one-third tubular plating techniques. Conclusion:We found no difference in biomechanical properties between locked and standard bridge plating of a comminuted Weber C fibular fracture in a model of catastrophic failure. It is likely that augmentation of fixation with K-wires or transtibial screws provides a construct superior to locked bridge plating alone. Further biomechanical and clinical analysis is required to improve understanding of the role of locked plating in ankle fractures and in osteoporotic bone.Contexte : Cette étude avait pour but de comparer les propriétés biomécaniques d'une plaque péronière latérale verrouillée ou non verrouillée dans des fractures de chevilles comminutives instables, en présence d'une défaillance catastrophique. Méthodes :Nous avons infligé des fractures comminutives de Weber de type C à 8 paires de membres de cadavres frais. Les fractures ont été corrigées au moyen de plaques tubulaires d'un tiers standard ou fixes. Les spécimens ont été évalués au plan biomécanique par rotation externe jusqu'à défaillance, tout en étant soumis à une charge compressive correspondant environ au poids corporel. Nous avons mesuré l'angle, le moment de torsion et l'énergie au point de défaillance et la rigidité de la structure.Résultats : Nous n'avons noté aucune différence significative sur le plan de la rigidité de la structure ou des autres propriétés biomécaniques entre les plaques tubulaires d'un tiers fixes et standard. Conclusion :Nous n'avons trouvé aucune différence sur le plan des propriétés biomécaniques entre les plaques standard et fixes sur des fractures péronières comminutives de Weber de type C dans un modèle de défaillance catastrophique. Il est probable qu'une fixation accrue au moyen de broches en K ou de vis transtibiales procure une meilleure structure que les plaques fixes seulement. Il faudra effectuer d'autres analyses biomécaniques et cliniques pour mieux comprendre le rôle des plaques fixes dans les fractures de la cheville et dans l'os ostéoporotique.

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Section: Resultsmentioning

confidence: 99%

“…The four cortices construct was the most common in other similar models. 27,28 We chose a model of catastrophic failure to create reproducible results. Pronation-external rotation was used to cause failure based on the presumption that the construct would be weakest by recreating the fracture mechanism.…”

Section: Researchmentioning

confidence: 99%

Locked plate fixation of the comminuted distal fibula: a biomechanical study

et al. 2013

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“…A posteriorly positioned plate allows use of a thicker, stronger plate, less risk of wound slough, and the distal screws can obtain better purchase since they engage a thicker part of distal fibula and engage 2 cortices without risk of joint penetration [54]. However, the plate can irritate peroneal tendons and will not allow syndesmosis screw insertion [55] [56].…”

Section: Comparison Of Different Fixation Techniquesmentioning

confidence: 99%

“…In contrast, the strength of the lateral locking plate construct was dependent on the screw-bone interface and failed with screw cut-out through soft bone. Furthermore, the posterior plate benefited from posteriorly to anteriorly directed bicortical screw fixation, whereas only unicortical fixation with shorter working lengths was possible through the lateral plate secondary distal tibiofibular articulation [55].…”

Section: Comparison Of Different Fixation Techniquesmentioning

confidence: 99%

Ankle Fractures: A Literature Review of Current Treatment Methods

Singh¹,

Kamal²,

Roulohamin³

et al. 2014

OJO

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Ankle fracture is one of the most common lower limb fractures for they account for 9% of all fractures representing a significant portion of the trauma workload. Ankle fractures usually affect young men and older women, however, below the age of 50; ankle fractures are the commonest in men. Two commonly used classification systems for ankle fractures include the danis weber AO classification and the Lauge-Hansen classification. There is biomechanical evidence that posterior non-locking plates are superior in stability than laterally placed plates; however there is little clinical evidence. There are several different methods of ankle fracture fixation, however the goal of treatment remains a stable anatomic reduction of talus in the ankle mortise and correction of the fibula length as a 1 mm lateral shift of the talus in the ankle mortise reduces the contact area by 42%, and displacement (or shortening) of the fibula more than 2 mm will lead to significant increases in joint contact pressures. Further research both biomechanically and clinically needs to be undertaken in order to clarify a preferable choice of fixation.

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“…More recently, however, potential disadvantages of this technique have arisen, including intra-articular screw placement distally, prominent or symptomatic lateral screws, inadequate distal fixation, loss of fixation, and wound complications [1,[4][5][6][7][8][9][10]. To mitigate these potential complications, the use of a posterior antiglide plate as a method of fibular fixation was proposed in the early 1980's.…”

Section: Introductionmentioning

confidence: 99%