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Vet Comp Orthop Traumatol 2013; 26(06): 479-488
DOI: 10.3415/VCOT-13-07-0089
Original Research
Schattauer GmbH

Ex vivo cyclic mechanical behaviour of 2.4 mm locking plates compared with 2.4 mm limited contact plates in a cadaveric diaphyseal gap model

I. Irubetagoyena
1   Université de Toulouse, INP, Ecole Nationale Vétérinaire de Toulouse, Unité de Recherche Clinique, Laboratoire de Biomécanique, Toulouse, France
,
M. Verset
1   Université de Toulouse, INP, Ecole Nationale Vétérinaire de Toulouse, Unité de Recherche Clinique, Laboratoire de Biomécanique, Toulouse, France
,
S. Palierne
1   Université de Toulouse, INP, Ecole Nationale Vétérinaire de Toulouse, Unité de Recherche Clinique, Laboratoire de Biomécanique, Toulouse, France
,
P. Swider
2   Université de Toulouse, Institut de Mécanique des Fluides, UMR CNR5 5502, Toulouse, France
,
A. Autefage
1   Université de Toulouse, INP, Ecole Nationale Vétérinaire de Toulouse, Unité de Recherche Clinique, Laboratoire de Biomécanique, Toulouse, France
› Author Affiliations
Further Information

Publication History

Received: 08 July 2013

Accepted: 31 July 2013

Publication Date:
04 January 2018 (online)

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Summary

Objectives: To compare the mechanical properties of locking compression plate (LCP) and limited contact dynamic compression plate (LC-DCP) constructs in an experimental model of comminuted fracture of the canine femur during eccentric cyclic loading.

Methods: A 20 mm mid-diaphyseal gap was created in eighteen canine femora. A 10-hole, 2.4 mm stainless steel plate (LCP or LC-DCP) was applied with three bicortical screws in each bone fragment. Eccentric cyclic loadings were applied at 10 Hertz for 610,000 cycles. Quasistatic loading / unloading cycles were applied at 0 and 10,000 cycles, and then every 50,000 cycles. Structural stiffness was calculated as the slope of the linear portion of the load-displacement curves during quasistatic loading / unloading cycles.

Results: No bone failure or screw loosening occurred. Two of the nine LCP constructs failed by plate breakage during fatigue testing, whereas no gross failure occurred with the LC-DCP constructs. The mean first stiffness of the LCP constructs over the course of testing was 24.0% lower than that of constructs stabilized by LC-DCP. Construct stiffness increased in some specimens during testing, presumably due to changes in boneplate contact. The first stiffness of LC-DCP constructs decreased by 19.4% and that of locked constructs by 34.3% during the cycling period. A biphasic stiffness profile was observed: the second stiffness was significantly greater than the first stiffness in both groups, which allowed progressive stabilization at elevated load levels.

Clinical significance: Because LCP are not compressed to the bone, they may have a longer working length across a fracture, and thus be less stiff. However, this may cause them to be more susceptible to fatigue failure if healing is delayed.

Keywords

Cyclic mechanical testing - locking plate - limited contact plate - gap model - femur - dogs
 

  • References

  • 1 Unger M, Montavon PM, Heim UF. Classification of fractures of long bones in the dog and cat: Introduction and clinical application. Vet Comp Orthop Traumatol 1990; 3: 41-50.
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 Braden TD, Eicker SW, Abdinoor D. et al. Characteristics of 1000 femur fractures in the dog and cat. Vet Comp Orthop Traumatol 1995; 8: 203-209.
    Thieme ConnectPubMedSearch in Google Scholar
  • 3 Aguila AZ, Manos JM, Orlansky AS. et al. In vitro biomechanical comparison of limited contact dynamic compression plate and locking compression plate. Vet Comp Orthop Traumatol 2005; 18: 220-226.
    Thieme ConnectPubMedSearch in Google Scholar
  • 4 Filipowicz D, Lanz O, McLaughlin R. et al. A biomechanical comparison of 3.5 locking compression plate fixation to 3.5 limited contact dynamic compression plate fixation in a canine cadaveric distal humeral metaphyseal gap model. Vet Comp Orthop Traumatol 2009; 22: 270-277.
    PubMedSearch in Google Scholar
  • 5 Fulkerson E, Egol KA, Kubiak EN. et al. Fixation of diaphyseal fractures with a segmental defect: a biomechanical comparison of locked and conventional plating techniques. J Trauma 2006; 60: 830-835.
    CrossrefPubMedSearch in Google Scholar
  • 6 Gardner MJ, Brophy RH, Campbell D. et al. The mechanical behavior of locking compression plates compared with dynamic compression plates in a cadaver radius model. J Orthop Trauma 2005; 19: 597-603.
    CrossrefPubMedSearch in Google Scholar
  • 7 Perren SM. Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology. J Bone Joint Surg Br 2002; 84: 1093-1110.
    CrossrefPubMedSearch in Google Scholar
  • 8 Blake CA, Boudrieau RJ, Torrance BS. et al. Single cycle to failure in bending of three standard and five locking plates and plate constructs. Vet Comp Orthop Traumatol 2011; 24: 408-417.
    Thieme ConnectPubMedSearch in Google Scholar
  • 9 Catanzarite J, Alan R, Baig R. et al. Biomechanical testing of unstable humeral shaft fracture plating. J Surg Orthop Adv 2009; 18: 175-181.
    PubMedSearch in Google Scholar
  • 10 Florin M, Arzdorf M, Linke B. et al. Assessment of stiffness and strength of 4 different implants available for equine fracture treatment: a study on a 20 degrees oblique long-bone fracture model using a bone substitute. Vet Surg 2005; 34: 231-238.
    CrossrefPubMedSearch in Google Scholar
  • 11 Snow M, Thompson G, Turner PG. A mechanical comparison of the locking compression plate (LCP) and the low contact-dynamic compression plate (DCP) in an osteoporotic bone model. J Orthop Trauma 2008; 22: 121-125.
    CrossrefPubMedSearch in Google Scholar
  • 12 Sod GA, Mitchell CF, Hubert JD. et al. In vitro biomechanical comparison of locking compression plate fixation and limited-contact dynamic compression plate fixation of osteotomized equine third metacarpal bones. Vet Surg 2008; 37: 283-288.
    CrossrefPubMedSearch in Google Scholar
  • 13 Strom AM, Garcia TC, Jandrey K. et al. In vitro mechanical comparison of 2.0 and 2.4 limited-contact dynamic compression plates and 2.0 dynamic compression plates of different thicknesses. Vet Surg 2010; 39: 824-828.
    CrossrefPubMedSearch in Google Scholar
  • 14 Will R, Englund R, Lubahn J. et al. Locking plates have increased torsional stiffness compared to standard plates in a segmental defect model of clavicle fracture. Arch Orthop Trauma Surg 2011; 131: 841-847.
    CrossrefPubMedSearch in Google Scholar
  • 15 Zahn K, Frei R, Wunderle D. et al. Mechanical properties of 18 different AO bone plates and the clamp-rod internal fixation system tested on a gap model construct. Vet Comp Orthop Traumatol 2008; 21: 185-194.
    Thieme ConnectPubMedSearch in Google Scholar
  • 16 Amato NS, Richards A, Knight TA. et al. Ex vivo biomechanical comparison of the 2.4 mm uniLOCK reconstruction plate using 2.4 mm locking versus standard screws for fixation of acetabular osteotomy in dogs. Vet Surg 2008; 37: 741-748.
    CrossrefPubMedSearch in Google Scholar
  • 17 Beingessner D, Moon E, Barei D. et al. Biomechanical analysis of the less invasive stabilization system for mechanically unstable fractures of the distal femur: Comparison of titanium versus stainless steel and bicortical versus unicortical fixation. J Trauma 2011; 71: 620-624.
    PubMedSearch in Google Scholar
  • 18 Borgeaud M, Cordey J, Leyvraz PE. et al. Mechanical analysis of the bone to plate interface of the LC-DCP and of the PC-FIX on human femora. Injury 2000; 31 Suppl 3 C29-36.
    CrossrefPubMedSearch in Google Scholar
  • 19 Bottlang M, Doornink J, Byrd GD. et al. A nonlocking end screw can decrease fracture risk caused by locked plating in the osteoporotic diaphysis. J Bone Joint Surg Am 2009; 91: 620-627.
    CrossrefPubMedSearch in Google Scholar
  • 20 Bottlang M, Doornink J, Fitzpatrick DC. et al. Far cortical locking can reduce stiffness of locked plating constructs while retaining construct strength. J Bone Joint Surg Am 2009; 91: 1985-1994.
    CrossrefPubMedSearch in Google Scholar
  • 21 Celestre P, Roberston C, Mahar A. et al. Biomechanical evaluation of clavicle fracture plating techniques: does a locking plate provide improved stability?. J Orthop Trauma 2008; 22: 241-247.
    CrossrefPubMedSearch in Google Scholar
  • 22 Dalstrom DJ, Nelles DB, Patel V. et al. The protective effect of locking screw placement on nonlocking screw extraction torque in an osteoporotic supracondylar femur fracture model. J Orthop Trauma 2012; 26: 523-527.
    CrossrefPubMedSearch in Google Scholar
  • 23 Davis C, Stall A, Knutsen E. et al. Locking plates in osteoporosis: a biomechanical cadaveric study of diaphyseal humerus fractures. J Orthop Trauma 2012; 26: 216-221.
    CrossrefPubMedSearch in Google Scholar
  • 24 Doornink J, Fitzpatrick DC, Boldhaus S. et al. Effects of hybrid plating with locked and nonlocked screws on the strength of locked plating constructs in the osteoporotic diaphysis. J Trauma 2010; 69: 411-417.
    CrossrefPubMedSearch in Google Scholar
  • 25 Estes C, Rhee P, Shrader MW. et al. Biomechanical strength of the Peri-Loc proximal tibial plate: a comparison of all-locked versus hybrid locked/nonlocked screw configurations. J Orthop Trauma 2008; 22: 312-316.
    CrossrefPubMedSearch in Google Scholar
  • 26 Forward DP, Doro CJ, O'Toole RV. et al. A biomechanical comparison of a locking plate, a nail, and a 95 degrees angled blade plate for fixation of subtrochanteric femoral fractures. J Orthop Trauma 2012; 26: 334-340.
    CrossrefPubMedSearch in Google Scholar
  • 27 Zlowodzki M, Williamson S, Cole PA. et al. Biomechanical evaluation of the less invasive stabilization system, angled blade plate, and retrograde intramedullary nail for the internal fixation of distal femur fractures. J Orthop Trauma 2004; 18: 494-502.
    CrossrefPubMedSearch in Google Scholar
  • 28 Hammel SP, Pluhar GE, Novo RE. et al. Fatigue analysis of plates used for fracture stabilization in small dogs and cats. Vet Surg 2006; 35: 573-578.
    CrossrefPubMedSearch in Google Scholar
  • 29 Rose BW, Pluhar GE, Novo RE. et al. Biomechanical analysis of stacked plating techniques to stabilize distal radial fractures in small dogs. Vet Surg 2009; 38: 954-960.
    CrossrefPubMedSearch in Google Scholar
  • 30 Stoffel K, Dieter U, Stachowiak G. et al. Biomechanical testing of the LCP - how can stability in locked internal fixators be controlled?. Injury 2003; 34 Suppl 2 B11-9.
    PubMedSearch in Google Scholar
  • 31 O'Toole RV, Andersen RC, Vesnovsky O. et al. Are locking screws advantageous with plate fixation of humeral shaft fractures? A biomechanical analysis of synthetic and cadaveric bone. J Orthop Trauma 2008; 22: 709-715.
    CrossrefPubMedSearch in Google Scholar
  • 32 Goh CS, Santoni BG, Puttlitz CM. et al. Comparison of the mechanical behaviors of semicontoured, locking plate-rod fixation and anatomically contoured, conventional plate-rod fixation applied to experimentally induced gap fractures in canine femora. Am J Vet Res 2009; 70: 23-29.
    CrossrefPubMedSearch in Google Scholar
  • 33 Lakes RS. Viscoelastic measurement techniques. Rev Sci Instrum 2004; 75: 797-810.
    CrossrefPubMedSearch in Google Scholar
  • 34 Turner CH, Burr DB. Basic biomechanical measurements of bone - a tutorial. Bone 1993; 14: 595-608.
    CrossrefPubMedSearch in Google Scholar
  • 35 Dueland RT, Vanderby R, McCabe RP. Fatigue study of six and eight mm diameter interlocking nails with screw holes of variable size and number. Vet Comp Orthop Traumatol 1997; 10: 194-199.
    Thieme ConnectPubMedSearch in Google Scholar
  • 36 Boutros CP, Trout DR, Kasra M. et al. The effect of repeated freeze-thaw cycles on the biomechanical properties of canine cortical bone. Vet Comp Orthop Traumatol 2000; 13: 59-64.
    Thieme ConnectPubMedSearch in Google Scholar
  • 37 Sanders R, Haidukewych GJ, Milne T. et al. Minimal versus maximal plate fixation techniques of the ulna: the biomechanical effect of number of screws and plate length. J Orthop Trauma 2002; 16: 166-171.
    CrossrefPubMedSearch in Google Scholar
  • 38 Fitzpatrick DC, Doornink J, Madey SM. et al. Relative stability of conventional and locked plating fixation in a model of the osteoporotic femoral diaphysis. Clin Biomech 2009; 24: 203-209.
    CrossrefPubMedSearch in Google Scholar
  • 39 Caja V, Kim W, Larsson S. et al. Comparison of the mechanical performance of three types of external fixators: linear, circular and hybrid. Clin Biomech 1995; 10: 401-406.
    CrossrefPubMedSearch in Google Scholar
  • 40 Demirhan M, Bilsel K, Atalar AC. et al. Biomechanical comparison of fixation techniques in midshaft clavicular fractures. J Orthop Trauma 2011; 25: 272-278.
    CrossrefPubMedSearch in Google Scholar
  • 41 Gardner MJ, Griffith MH, Demetrakopoulos D. et al. Hybrid locked plating of osteoporotic fractures of the humerus. J Bone Joint Surg Am 2006; 88: 1962-1967.
    PubMedSearch in Google Scholar
  • 42 Guiot LP, Dejardin LM. Prospective Evaluation of minimally invasive plate osteosynthesis in 36 nonarticular tibial fractures in dogs and cats. Vet Surg 2011; 40: 171-182.
    CrossrefPubMedSearch in Google Scholar
  • 43 Haaland PJ, Sjostrom L, Devor M. et al. Appendicular fracture repair in dogs using the locking compression plate system: 47 cases. Vet Comp Orthop Traumatol 2009; 22: 309-315.
    Thieme ConnectPubMedSearch in Google Scholar
  • 44 Chao P, Conrad BP, Lewis DD. et al. Effect of plate working length on plate stiffness and cyclic fatigue life in a cadaveric femoral fracture gap model stabilized with a 12-hole 2.4 mm locking compression plate. BMC Vet Res 2013; 9: 125-131.
    CrossrefPubMedSearch in Google Scholar
  • 45 Kubiak EN, Fulkerson E, Strauss E. et al. The evolution of locked plates. J Bone Joint Surg Am 2006; 88 Suppl 4 189-200.
    PubMedSearch in Google Scholar
  • 46 Pozzi A, Risselada M, Winter MD. Assessment of fracture healing after minimally invasive plate osteosynthesis or open reduction and internal fixation of coexisting radius and ulna fractures in dogs via ultrasonography and radiography. J Am Vet Med Assoc 2012; 241: 744-753.
    CrossrefPubMedSearch in Google Scholar
  • 47 Sarrau S, Meige F, Autefage A. Treatment of femoral and tibial fractures in puppies by elastic plate osteosynthesis - A review of 17 cases. Vet Comp Orthop Traumatol 2007; 20: 51-58.
    Thieme ConnectPubMedSearch in Google Scholar
  • 48 Wagner M. General principles for the clinical use of the LCP. Injury 2003; 34 Suppl 2 B31-42.
    CrossrefPubMedSearch in Google Scholar
  • 49 Cabassu JP. Elastic plate osteosynthesis of femoral shaft fractures in young dogs. Vet Comp Orthop Traumatol 2001; 14: 40-45.
    Thieme ConnectPubMedSearch in Google Scholar
  • 50 Garofolo S, Pozzi A. Effect of plating technique on periostal vasculature of the radius in dogs: a cadaver study. Vet Surg 2013; 42: 255-261.
    CrossrefPubMedSearch in Google Scholar
  • 51 Baroncelli AB, Peirone B, Winter MD. et al. Retrospective comparison between minimally invasive plate osteosynthesis and open plating for tibial fractures in dogs. Vet Comp Orthop Traumatol 2012; 25: 410-417.
    Thieme ConnectPubMedSearch in Google Scholar
  • 52 Palierne S. Quantification objective de la géométrie et du comportement biomécanique du fémur dans l'espèce canine: application à quatre groupes morphologiques [Objective quantification of geometry and biomechanical behavior of femur in canine species: application to four mophological groups] [PhD Dissertation]. Toulouse: Toulouse; 2006
    Search in Google Scholar
  • 53 Taylor SJ, Walker PS. Forces and moments telemetered from two distal femoral replacements during various activities. J Biomech 2001; 34: 839-848.
    CrossrefPubMedSearch in Google Scholar