Multidirectional volar fixed-angle plating using cancellous locking screws for distal radius fractures – Evaluation of three screw configurations in an extra-articular fracture model

Weninger, Patrick; Dall’Ara, Enrico; Drobetz, Herwig; Nemec, Wolfgang; Figl, Markus; Redl, Heinz; Hertz, H.; Zysset, Philippe

doi:10.1007/s00508-010-1488-9

Cited by 11 publications

(8 citation statements)

References 27 publications

(32 reference statements)

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“…No significant difference could be found for screw-bone failure between the two fracture models, despite the different distal bone stock volume; this is in line with recent studies by Greenberg et al [23] and Weninger et al [24]. Greenberg et al [23] investigated the effect of the depth of screw insertion within the distal radius on fracture stability and found no significant difference between the three groups (bicortical vs. monocortical to the distal cortex vs. monocortical 75% to the distance of the distal cortex).…”

Section: Discussionsupporting

confidence: 91%

“…Greenberg et al [23] investigated the effect of the depth of screw insertion within the distal radius on fracture stability and found no significant difference between the three groups (bicortical vs. monocortical to the distal cortex vs. monocortical 75% to the distance of the distal cortex). Weninger et al [24] compared three different screw configurations using a biomechanical synthetic model and again found no significant difference between the three groups (distal row only, two rows of screws: one group with parallel, the other with the proximal row inclined screws).…”

Section: Discussionmentioning

confidence: 99%

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Assessment of a novel biomechanical fracture model for distal radius fractures

Baumbach

Dall’Ara

Weninger

et al. 2012

BMC Musculoskelet Disord

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BackgroundDistal radius fractures (DRF) are one of the most common fractures and often need surgical treatment, which has been validated through biomechanical tests. Currently a number of different fracture models are used, none of which resemble the in vivo fracture location. The aim of the study was to develop a new standardized fracture model for DRF (AO-23.A3) and compare its biomechanical behavior to the current gold standard.MethodsVariable angle locking volar plates (ADAPTIVE, Medartis) were mounted on 10 pairs of fresh-frozen radii. The osteotomy location was alternated within each pair (New: 10 mm wedge 8 mm / 12 mm proximal to the dorsal / volar apex of the articular surface; Gold standard: 10 mm wedge 20 mm proximal to the articular surface). Each specimen was tested in cyclic axial compression (increasing load by 100 N per cycle) until failure or −3 mm displacement. Parameters assessed were stiffness, displacement and dissipated work calculated for each cycle and ultimate load. Significance was tested using a linear mixed model and Wald test as well as t-tests.Results7 female and 3 male pairs of radii aged 74 ± 9 years were tested. In most cases (7/10), the two groups showed similar mechanical behavior at low loads with increasing differences at increasing loads. Overall the novel fracture model showed a significant different biomechanical behavior than the gold standard model (p < 0,001). The average final loads resisted were significantly lower in the novel model (860 N ± 232 N vs. 1250 N ± 341 N; p = 0.001).ConclusionThe novel biomechanical fracture model for DRF more closely mimics the in vivo fracture site and shows a significantly different biomechanical behavior with increasing loads when compared to the current gold standard.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Assessment of a novel biomechanical fracture model for distal radius fractures

Baumbach

Dall’Ara

Weninger

et al. 2012

BMC Musculoskelet Disord

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“…A second distal screw row does not have any positive influence on postoperative radial shortening. This is in accordance with biomechanical studies[ 12 , 14 , 24 - 26 ].…”

Section: Discussionsupporting

confidence: 93%

Screw placement is everything: Risk factors for loss of reduction with volar locking distal radius plates

Drobetz

Black

Davies

et al. 2018

WJO

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AIMTo determine factors correlated with postoperative radial shortening in patients with distal radius fractures treated with volar locking distal radius plates.METHODSA total of 250 patients with a distal radius fracture stabilised with volar locking plates between January 2010 and December 2014 were included in a multicentre retrospective cohort study. We measured the distance of the distal locking screws to the joint line immediately postoperatively and then measured radial shortening after six to eight weeks using the change in ulnar variance.RESULTSMultivariate linear regression analysis showed that there was a significant linear association between the distance of the screws from the joint line and radial shortening. No other patient, injury, or treatment-related characteristic significantly influenced radial shortening in multivariate analysis.CONCLUSIONDistal locking screws should be placed as close as possible to the subchondral joint line to prevent postoperative loss of reduction.

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“…Numerous biomechanical studies have analyzed VLPs: comparing fixed-angle with variable-angle screws, 28 intraarticular 10,12,13,15,17,28 and extraarticular fractures, 16,29,30 number of distal screws, 12,13,29,30 screw diameter, 10 and influence of plate positioning on construct stability. 16 The present study adds to this body of evidence by evaluating the biomechanical strength of variable-angle plates at different positions of a complex distal radius fracture.…”

Section: Discussionmentioning

confidence: 99%

Can the Use of Variable-Angle Volar Locking Plates Compensate for Suboptimal Plate Positioning in Unstable Distal Radius Fractures? A Biomechanical Study

Hart¹,

Collins²,

Chhatwal

et al. 2015

Journal of Orthopaedic Trauma

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Multidirectional volar fixed-angle plating using cancellous locking screws for distal radius fractures – Evaluation of three screw configurations in an extra-articular fracture model

Abstract: Considering the limitations of the study, the recommendation to use two rows of screws or to place screws in the proximal metaphyseal row with inclination cannot be supported by our mechanical data.

Cited by 11 publications

References 27 publications

Assessment of a novel biomechanical fracture model for distal radius fractures

Assessment of a novel biomechanical fracture model for distal radius fractures

Screw placement is everything: Risk factors for loss of reduction with volar locking distal radius plates

Can the Use of Variable-Angle Volar Locking Plates Compensate for Suboptimal Plate Positioning in Unstable Distal Radius Fractures? A Biomechanical Study

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