Externalised locking compression plate as an alternative to the unilateral external fixator: a biomechanical comparative study of axial and torsional stiffness

Ang, Benjamin; Chen, J. Y.; Yew, Andy Khye Soon; Chua, S. K.; Chou, Siaw Meng; Chia, Shi‐Lu; Koh, Joyce Suang Bee; Howe, Tet-Sen

doi:10.1302/2046-3758.64.2000470

Cited by 31 publications

(41 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…(P= 0.171). However, there was a significant difference in mean torsional between LCP (stainless steel) (0.639 N/mm) (0.686 Nm/degree) LCP (titanium) and EF (0.512 Nm/degree) (P=0.013) [4] . That study used 15 synthetic tibias bone model and standard AO technique for the fixation of construct.…”

Section: Biomechanical Studiesmentioning

confidence: 87%

“…In the early years, the aim of plate fixation outside the skin was to reduce the stress on bone and periosteum. In 1987, there was one biomechanical study regarding external plate fixation using Zesopl osteosynthesis system [4][5] . This initial study was not to use alternative to the traditional external fixator in the management of open fracture but to replace the compression plate in the treatment of closed fractures.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Supracutaneous plate: A comparable alternative to external fixator in the treatment of open fracture

Thein¹,

Mohamad²,

Lwin³

et al. 2018

Int. J. Orthop. Sci.

View full text Add to dashboard Cite

Open fracture is one of the common health care problems in clinical orthopedic practice. Incidence of open fracture rate is increasing, especially in working age groups in industrialized society. Treatment of open fractures is still challenging since surgeons have to tackle not only fracture and also risk of infection, soft tissue coverage and neurovascular injury. Traditionally, external fixator (EF) device was used to fix the open fracture as an emergency or definitive management. In recent years, there was the introduction of locked compression plate (LCP) as an alternative to the conventional external fixator. There are not too many studies regarding the outcome, biomechanics and complications regarding LCP as an external fixator. Based on the available resources, we have reviewed some journals. We would like to comment that usage of LCP as an external fixator in the treatment of long bone fractures shows acceptable outcome. There is no significant difference in operation time between LCP and EF. The rates of union and complication are comparable to that of the conventional external fixator. There is no enough report about a biomechanical comparison study between LCP and EF. Patient acceptance may be higher in LCP than in EF however; there is very little research for the time being. We would like to recommend further research in this area.

show abstract

Section: Biomechanical Studiesmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Supracutaneous plate: A comparable alternative to external fixator in the treatment of open fracture

Thein¹,

Mohamad²,

Lwin³

et al. 2018

Int. J. Orthop. Sci.

View full text Add to dashboard Cite

show abstract

“…In the technique “supercutaneous plating” by Kloen, the LCP can be used as an external fixator for treatment of distal tibial fractures and humeral infected nonunion. In a biomechanical comparative study of axial and torsional stiffness by Ang et al ,. LCP was used as an external fixator in comparison with UEF.…”

Section: Discussionmentioning

confidence: 99%

“…It seems an attractive technique to deal with fractures involving complex wounds or to improve the tolerability of treatment. It has been reported that externalized LCP could act an alternative to the unilateral external fixator (UEF) for treating distal tibial fractures, and the axial and torsional stiffness are not compromised. Although this new technique still has some deficiencies, such as potential screw channel infections and inconvenience for nurses, it provides us with a new concept for clinical treatment of distal‐third diaphyseal humerus fractures.…”

Section: Introductionmentioning

confidence: 99%

Lateral Subcutaneous Locking Compression Plate and Small Incision Reduction for Distal‐third Diaphyseal Humerus Fractures

Chang

Yao

Hou

et al. 2018

Orthopaedic Surgery

View full text Add to dashboard Cite

ObjectiveIatrogenic radial nerve injury is a great challenge for orthopaedic surgeons who deal with distal‐third diaphyseal humerus fractures. Conventional open reduction and internal fixation (ORIF) remains the gold standard, but complications such as nonunion and iatrogenic radial nerve injury still occur. We fixed the fractures with a lateral locking compression plate (LCP) subcutaneously after small incision reduction to protect the radial nerve. This study reports the clinical and radiographic outcomes of our modified method.MethodsThirty‐eight patients with distal‐third diaphyseal humerus fractures were treated with lateral subcutaneous LCP and small incision reduction at our department between September 2013 and August 2016. There were 33 males and 5 females, with an average age of 30.3 years (range, 17 to 49 years). All the cases were types A or B (AO/OTA classification, type A, 24 cases; type B, 14 cases). Among them, 6 cases were combined with preoperative radial nerve palsy. All patients were diagnosed with closed humeral fractures after X‐ray examination, and had typical upper limb pain, swelling, and movement disorders. The operations were performed by a single surgeons’ team. Union time, range of motion (ROM), University of California, Los Angeles (UCLA) shoulder rating scale, and Mayo Elbow Performance Index (MEPI) scores were assessed to evaluate the postoperative results.ResultsAll patients were followed up for an average of 11.4 months (range, 3 to 36 months). The average operation time was 75.5 min (range, 60 to 150 min) and average intraoperative radiation exposure was 10.5 s (range, 8 to 18 s). Bony union was achieved in all cases after an average of 16.2 weeks (range, 12 to 25 weeks). No complications such as infection or screw and plate fracture occurred, and no iatrogenic radial nerve injury was observed. According to the UCLA shoulder rating scale, the average score was 33.7 (range, 31 to 35), with 33 excellent (86.8%) and 5 good cases (13.2%). They were all excellent according to their MEPI scores (ranging, 94 to 100, with an average of 97.4). The average operation time for secondary removal of the plate was 15.2 min (range, 10 to 20 min), and no complications such as infection or secondary radial nerve injury occurred.ConclusionsLateral subcutaneous LCP and small incision reduction may reduce the risk of iatrogenic radial nerve injury significantly in the treatment of distal‐third diaphyseal humerus fractures. It also leads to solid fixation, good postoperative function, and convenient removal of the plate without injuring the radial nerve.

show abstract

“…The stiffness of external fixators reported in previous literatures has ranged from 50 N/mm to 2500 N/mm in axial compression, 10 Nm/deg to 100 Nm/deg in four-point bending, and 1 Nm/deg to 4 Nm/deg in torsion, respectively (4,6,(28)(29)(30)(31). The stiffness values of all of the bone-implant constructs in our study research were within these ranges, and the plate-type external fixator provided remarkably higher torsional stiffness than the UEF.…”

Section: Construct Stiffnessmentioning

confidence: 99%

Investigating the biomechanical function of the plate-type external fixator in the treatment of tibial fractures : a biomechanical study

Shi

Liu

Zhang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background The design of an external fixator with the optimal biomechanical function and the lowest profile has been highly pursued, as fracture healing is dependent on the stability and durability of fixation, and a low profile is more desired by patients. The plate-type external fixator, a novel prototype of an external tibial fixation device, is a low profile construct. However, its biomechanical properties remain unclear. The objective of this study was to investigate the stiffness and strength of the plate-type external fixator and the unilateral external fixator. We hypothesized that the plate-type external fixator could provide higher stiffness while retaining sufficient strength. Methods Fifty-four cadaver tibias underwent a standardized midshaft osteotomy to create a fracture gap model to simulate a comminuted diaphyseal fracture. All specimens were randomly divided into three groups of eighteen specimens each and stabilized with either a unilateral external fixator or two configurations of the plate-type external fixator. Six specimens of each configuration were tested to determine fixation stiffness in axial compression, four-point bending, and torsion, respectively. Afterwards, dynamic loading until failure was performed in each loading mode to determine the construct strength and failure mode. Results The plate-type external fixator provided higher stiffness and strength than the traditional unilateral external fixator. The highest biomechanics were observed for the classical plate-type external fixator, closely followed by the extended plate-type external fixator. Conclusions The plate-type external fixator is stiffer and stronger than the traditional unilateral external fixator under axial compression, four-point bending and torsion loading conditions.

show abstract

Externalised locking compression plate as an alternative to the unilateral external fixator: a biomechanical comparative study of axial and torsional stiffness

Cited by 31 publications

References 43 publications

Supracutaneous plate: A comparable alternative to external fixator in the treatment of open fracture

Supracutaneous plate: A comparable alternative to external fixator in the treatment of open fracture

Lateral Subcutaneous Locking Compression Plate and Small Incision Reduction for Distal‐third Diaphyseal Humerus Fractures

Investigating the biomechanical function of the plate-type external fixator in the treatment of tibial fractures : a biomechanical study

Contact Info

Product

Resources

About