Threaded Screw Head Inserts Improve Locking Plate Biomechanical Properties

Bellapianta, Joseph M.; Dow, Kyle; Pallotta, Nicholas A.; Hospodar, Paul P.; Uhl, Richard L.; Ledet, Eric H.

doi:10.1097/bot.0b013e3181dc56b1

Cited by 20 publications

(22 citation statements)

References 18 publications

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“…The combination of these reduced the local stresses at the screw holes adjacent to the defect and increased fatigue life. These results are consistent with those of a previous study using locking buttons in one-third tubular plates [2]. In another study, locking buttons did not increase fatigue life [11].…”

Section: Discussionsupporting

confidence: 92%

“…The plates used in this study also were stainless steel, however, testing in that study was performed using peak loads slightly greater than the elastic limit, whereas we used loads that were 65% of the elastic limit. All the plates in that study [19] and ours broke through the screw holes closest to the defect, consistent with two additional studies that showed the greatest amount of stress in the plate is at the screw holes nearest the defect [2,24].…”

Section: Discussionsupporting

confidence: 84%

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Locking Buttons Increase Fatigue Life of Locking Plates in a Segmental Bone Defect Model

Tompkins

Paller

Moore

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Durability of plate fixation is important in delayed union. Although locking plates result in stronger constructs, it is not known if locking affects the fatigue life of a plate. Two locking screws on either side of the nonunion could decrease working length and increase strain in the plate. However, the reinforcing effect of the locking head on the plate may compensate, so that it is unclear whether locking reduces fatigue life.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 84%

Locking Buttons Increase Fatigue Life of Locking Plates in a Segmental Bone Defect Model

Tompkins

Paller

Moore

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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show abstract

“…Because the plug is mechanically connected, rather than bonded or welded, to the plate, one would expect its mechanical effects to be sensitive to the design of the screw hole. Thus, while the results of Bellapianta et al 11 show promise for the use of screw plugs in improving plate fatigue strength, it is important to evaluate the use of plugs for different plate geometries and under multi-axial physiological loading conditions.…”

mentioning

confidence: 96%

Does plugging unused combination screw holes improve the fatigue life of fixation with locking plates in comminuted supracondylar fractures of the femur?

Firoozabadi¹,

McDonald²,

Tq³

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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Filling the empty holes in peri-articular locking plates may improve the fatigue strength of the fixation. The purpose of this in vitro study was to investigate the effect of plugging the unused holes on the fatigue life of peri-articular distal femoral plates used to fix a comminuted supracondylar fracture model. A locking/compression plate was applied to 33 synthetic femurs and then a 6 cm metaphyseal defect was created (AO Type 33-A3). The specimens were then divided into three groups: unplugged, plugged with locking screw only and fully plugged holes. They were then tested using a stepwise or run-out fatigue protocol, each applying cyclic physiological multiaxial loads. All specimens in the stepwise group failed at the 770 N load level. The mean number of cycles to failure for the stepwise specimen was 25,500 cycles (SD 1500), 28,800 cycles (SD 6300), and 26,400 cycles (SD 2300) cycles for the unplugged, screw only and fully plugged configurations, respectively (p = 0.16). The mean number of cycles to failure for the run-out specimens was 42,800 cycles (SD 10,700), 36,000 cycles (SD 7200), and 36,600 cycles (SD 10,000) for the unplugged, screw only and fully plugged configurations, respectively (p = 0.50). There were also no differences in axial or torsional stiffness between the constructs. The failures were through the screw holes at the level of comminution. In conclusion, filling the empty combination locking/compression holes in peri-articular distal femur locking plates at the level of supracondylar comminution does not increase the fatigue life of the fixation in a comminuted supracondylar femoral fracture model (AO 33-A3) with a 6 cm gap.

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“…6,9,11,26,47,56 The trend in marketing to foot and ankle surgeons is to use locking plates and screws that are thinner, precontoured, and made of titanium. There is little evidence, however, to support these concepts biomechanically or clinically.…”

Section: Clinical Considerationsmentioning

confidence: 99%

Topical Review

Jastifer¹

2014

Foot Ankle Int.

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The use of locking plate technology in foot and ankle surgery has increased over the last decade. Reported applications include fracture repair, deformity correction, and arthrodesis. There is limited evidence, however, to guide clinicians with regard to the appropriate and optimal use of this technology. This work aims to examine the current biomechanical and clinical evidence comparing locking construct technology to other forms of fixation in the field of foot and ankle surgery.

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Threaded Screw Head Inserts Improve Locking Plate Biomechanical Properties

Cited by 20 publications

References 18 publications

Locking Buttons Increase Fatigue Life of Locking Plates in a Segmental Bone Defect Model

Locking Buttons Increase Fatigue Life of Locking Plates in a Segmental Bone Defect Model

Does plugging unused combination screw holes improve the fatigue life of fixation with locking plates in comminuted supracondylar fractures of the femur?

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