Polyaxial versus Uniaxial Volar Locking Plate for Distal Radial Fractures

Al-Mouazzen, Louay; Chou, David; Kyriakopoulos, Georgios; Hambidge, John

doi:10.1177/230949901402200105

Cited by 11 publications

(3 citation statements)

References 13 publications

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“…6 In human, medicine biomechanical and clinical studies show good results with the use of PLS. [7][8][9][10] For the veterinary PLS, no study so far has evaluated the differences in stability of screws placed in monoaxial compared with polyaxial fashion.…”

Section: Introductionmentioning

confidence: 99%

Mechanical Performance of a Polyaxial Locking Plate and the Influence of Screw Angulation in a Fracture Gap Model

Kaczmarek¹,

Bartkowiak

Schuenemann³

et al. 2019

Vet Comp Orthop Traumatol

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Objective The aim of this study was to compare the locking compression plate (LCP) with polyaxial locking system (PLS) using single cycle to failure 4-point bending test and to investigate the behaviour of PLS with screws inserted mono- and polyaxially using cyclic fatigue test in two bending directions. Materials and Methods Tests were performed on bone surrogates in a fracture gap model. The 3.5 LCP and 3.5 PLS plates were tested in single cycle to failure. The 3.5 PLS plates with mono- and polyaxial screws were compared in a cyclic fatigue tests in two orthogonal directions. For both experiments, micro-computed tomography (CT) scans were performed pre- and post-testing to investigate the connections between the screw head and the plate hole. Means of forces and cycles needed to failure were statistically compared. Results The PLS plates were on average 30% weaker than LCP plates. Mode of failure was plate bending in the single cycle to failure tests, and plate breakage in the cyclic fatigue tests. Neither screw breakage nor loss of the screw–plate interface occurred. Mono- and polyaxial constructs performed similarly when loaded in the same direction. Micro-CT revealed no additional internal cracks in the plates or screws after testing. It also showed for both PLS and LCP that there was only partial contact of the screw head with the plate hole. Clinical Relevance PLS offers a durable locking system, even when the screws are placed polyaxially. The weaker bending properties of the PLS compared with LCP should be considered during preoperative planning.

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Section: Introductionmentioning

confidence: 99%

Mechanical Performance of a Polyaxial Locking Plate and the Influence of Screw Angulation in a Fracture Gap Model

Kaczmarek¹,

Bartkowiak

Schuenemann³

et al. 2019

Vet Comp Orthop Traumatol

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“…After four days of damage, he underwent surgery with an independent angle locking plate and femur fixation. A 12-month follow-up period was seen in 87 patients with distal fractures of various kinds (11). Its worries the polyaxial volar locking plate system allowed deeper insertion of distal screws into the subchondral bone, thereby providing better buttress for the fracture fragments.…”

Section: Discussionmentioning

confidence: 99%

Comparison between two techniques for distal radial fractures management

2023

jjoas-n

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Background: One of the most frequent fractures found are distal radius fractures. For less displaced fractures, closed reduction and casting is the preferred method of treatment; for more difficult fractures, open reduction and internal fixation (ORIF) is used. ORIF helps to restore the anatomy of the wrist, facilitating quicker recovery and improving therapeutic results. Patients and Methods: We examined 32 terminal radius cracks that were repaired on between August 2019 and April 2021 using variable-angle volar locking plates. With periods of follow-up varying from six to eighteen, the patients' mean age was 41 years, with a range of 22 to 60. With an alternate angle volar locking plate, sixteen patients endured open reduction and internal fixation, while sixteen more patients acquired a fixed angle volar locking plate using a modified Henry technique. Following a 6-month period, a comprehensive assessment was conducted, encompassing wrist range of motion as determined by a goniometer, discomfort, tendon functions to assess the potential for tendon rupture or tenosynovitis, and median nerve functions. Complete fracture consolidation was ensured using X-rays. According to VAS, Mayo, and QDASH, clinical outcomes were assessed. Results: Hand dominance and the ultimate score were closely linked. The ultimate clinical outcome did not correlate with sex or occupation, but it did correlate with age and smoking habit. Conclusion: this study revealed that volar locking plates with angle-stabilized screws, is starting to be applied extensively. It is safe and efficient to treat comminuted distal radius fractures with a volar variable angle plate fixation. By using these plates, hardware complications are significantly reduced and outstanding and good functional outcomes are associated.

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“…11 Variable angle volar plates can achieve better subchondral screw placement and provides better stability for the fracture fragments. 12 The main objective of this randomised prospective study was to compare functional outcome between fixed angle volar plate and variable angle volar plate in intra-articular distal end radius fractures by using PRHWE score and radiological outcomes between fixed angle volar plate and variable angle volar plate by radial height, volar tilt, and radial inclination.…”

Section: Introductionmentioning

confidence: 99%

A comparative study between variable and fixed angle volar locking plates in management of unstable intra-articular distal radius fractures

et al. 2020

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Background: The current study is conducted to assess and compare the radiological and functional outcomes between variable and fixed angle volar plating in unstable intra-articular distal radius fractures.Methods: A prospective study was conducted from May 2018 to May 2020. A total of 156 patients were randomised into two groups A and B of 78 patients each. The plates were T or oblique fixed angle volar plate in group A and variable angle volar plate in group B. Patients were followed up for minimum 12 months. The functional outcome was measured by patient rated hand wrist evaluation score (PRHWE) and radiological outcome by radial height, volar tilt and radial inclination. The secondary objective was to correlate complications.Results: In our study average PRHWE score was better in group B (p<0.05). Radial height, volar tilt, radial inclination was much closer to anatomical wrist radiology was seen in group B. The most common complication was finger and wrist stiffness in group A.Conclusions: Patients treated with variable angle volar plate showed better results in functional and radiological outcomes at 12 months follow-up but limitations include short duration of follow up.

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Polyaxial versus Uniaxial Volar Locking Plate for Distal Radial Fractures

Cited by 11 publications

References 13 publications

Mechanical Performance of a Polyaxial Locking Plate and the Influence of Screw Angulation in a Fracture Gap Model

Mechanical Performance of a Polyaxial Locking Plate and the Influence of Screw Angulation in a Fracture Gap Model

Comparison between two techniques for distal radial fractures management

A comparative study between variable and fixed angle volar locking plates in management of unstable intra-articular distal radius fractures

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