Mini and micro plating of phalangeal and metacarpal fractures: A biomechanical study

Prevel, Christopher D.; Eppley, Barry L.; Jackson, Joshua; Moore, Keith; McCarty, Michael; Wood, Rajiv

doi:10.1016/s0363-5023(05)80057-7

Cited by 49 publications

(33 citation statements)

References 10 publications

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“…Thus, a test protocol which gradually increases the loading with each cycle was chosen. This is in contrast with other studies that use quasistatic or fatigue type cyclic loading (Black et al, 1986;Firoozbakhsh et al, 1993;Prevel et al, 1995).…”

Section: Discussioncontrasting

confidence: 58%

“…Rigidity of various fixation methods was investigated in previous studies (Afshar et al, 2012;Black et al, 1986;Lu et al, 1996;Nunley and Kloen, 1991;Ouellette et al, 2004;Prevel et al, 1995). Most of them were conducted applying quasistatic loading, which is less representative for the repetitive movements encountered during rehabilitation, or three-point bending of the fingers with limited physiological relevance.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, there is no consensus regarding the predominant loading type of the fingers during rehabilitation following a phalanx fracture (An et al, 1985;Berme et al, 1977;Wu et al, 2008). In spite of this and the paucity of supporting data, dorsal plating is widely used for phalangeal fracture fixation due to its straightforward approach and the assumption that thereby a stabilizing tension band effect is achieved (Black et al, 1986;Prevel et al, 1995). One of the most commonly used implants for phalanx fractures is the T-plate (DePuy Synthes, Solothurn, Switzerland), available as 1.5 mm non-locking and locking plate, that can be used for both dorsal and lateral application by trimming and shaping the plate accordingly.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Angular stable lateral plating is a valid alternative to conventional plate fixation in the proximal phalanx. A biomechanical study

Shanmugam

Ernst

Stoffel

et al. 2015

Clinical Biomechanics

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Section: Discussioncontrasting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Angular stable lateral plating is a valid alternative to conventional plate fixation in the proximal phalanx. A biomechanical study

Shanmugam

Ernst

Stoffel

et al. 2015

Clinical Biomechanics

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“…Several biomechanical studies have assessed various methods of internal fixation of metacarpals Mann et al, 1985;Massengill et al, 1982;Prevel (116) No significant differences between the two groups for BMD, load to failure and stiffness. BMD=Bone mineral density.…”

Section: Discussionmentioning

confidence: 99%

Plating of Metacarpal Fractures: Unicortical or Bicortical Screws?

Dona

Gillies

Gianoutsos

et al. 2004

Journal of Hand Surgery

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Mid-shaft transverse osteotomies were performed in 18 cadaveric metacarpals and randomly divided into two groups. Using dorsally applied plates for repair, one group was secured using 6mm unicortical screws, while bicortical screws were used in the second group. The metacarpals were tested to failure with a four-point bending protocol using a servo-hydraulic testing machine and a 1kN load cell. The mean load to failure was 596N (SD=142) for the unicortical and 541N (SD=171) for the bicortical group. The stiffness was 333N/mm (SD=116) for the unicortical and 458N/mm (SD=158) for the bicortical group. Both load to failure and stiffness were not statistically significant between the two groups. Failure occurred by fracture at the screw-bone interface in all specimens: no screw pull-out was observed. No biomechanical advantage was found when using bicortical screws in metacarpal fracture plating.

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“…Comparing the different techniques of osteosynthesis for metacarpal fracture stabilisation the combination of a dorsal plate and lag screw has been shown in biomechanical studies to be stronger than other fixation methods [2][3][4]. Prevel et al found that a three-dimensional design is associated with increased rigidity [5,6]. New locking plates have been invented for hand surgery and are already often used in clinics.…”

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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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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Mini and micro plating of phalangeal and metacarpal fractures: A biomechanical study

Cited by 49 publications

References 10 publications

Angular stable lateral plating is a valid alternative to conventional plate fixation in the proximal phalanx. A biomechanical study

Angular stable lateral plating is a valid alternative to conventional plate fixation in the proximal phalanx. A biomechanical study

Plating of Metacarpal Fractures: Unicortical or Bicortical Screws?

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

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