Is augmented femoral lateral plating with helically shaped medial plates biomechanically advantageous over straight medial plates?

Autor: Pastor T; AO Research Institute Davos, Davos, Switzerland.; Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland., Zderic I; AO Research Institute Davos, Davos, Switzerland., Drenchev L; Bulgarian Academy of Sciences, Institute of Metal Science 'Acad. A. Balevski', Sofia, Bulgaria., Skulev HK; Bulgarian Academy of Sciences, Institute of Metal Science 'Acad. A. Balevski', Sofia, Bulgaria., Berk T; AO Research Institute Davos, Davos, Switzerland.; Department of Trauma, University Hospital Zurich, Zurich, Switzerland., Beeres FJP; Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland.; Department of Health Science and Medicine, University of Lucerne, Lucerne, Switzerland., Link BC; Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland., Gueorguiev B; AO Research Institute Davos, Davos, Switzerland., Stoffel K; Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland., Knobe M; Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland.; Medical Faculty, RWTH Aachen University Hospital, Aachen, Germany.
Jazyk: angličtina
Zdroj: Journal of orthopaedic research : official publication of the Orthopaedic Research Society [J Orthop Res] 2024 Apr; Vol. 42 (4), pp. 886-893. Date of Electronic Publication: 2023 Nov 29.
DOI: 10.1002/jor.25730
Abstrakt: Dual plating of comminuted distal femoral fractures allows for early patient mobilization. An additional helically shaped medial plate avoids the medial vital structures of the thigh. The aim of this study is to investigate the biomechanical competence of an augmented lateral locking compression plate distal femur (LCP-DF) using an additional straight versus a helically shaped medial LCP of the same length. Ten pairs of human cadaveric femora were instrumented with a lateral anatomical 15-hole LCP-DF. Following, they were pairwise instrumented with either an additional medial straight 14-hole LCP (group 1) or a 90°-helical shape LCP (group 2). All specimens were biomechanically tested under quasi-static and progressively increasing combined cyclic axial and torsional loading until failure. Initial interfragmentary axial displacement and flexion under static compression were significantly smaller in group 1 (0.11 ± 0.12 mm and 0.21 ± 0.10°) versus group 2 (0.31 ± 0.14 mm and 0.68 ± 0.16°), p ≤ 0.007. Initial varus deformation under static compression remained not significantly different between group 1 (0.57 ± 0.23°) and group 2 (0.75 ± 0.34°), p = 0.085. Flexion movements during dynamic loading were significantly bigger in group 2 (2.51 ± 0.54°) versus group 1 (1.63 ± 1.28°), p = 0.015; however, no significant differences were observed in terms of varus, internal rotation, and axial and shear displacements between the groups, p ≥ 0.204. Cycles to failure and load at failure were higher in group 2 (25,172 ± 6376 and 3017 ± 638 N) compared to group 1 (22,277 ± 4576 and 2728 ± 458 N) with no significant differences between them, p = 0.195. From a biomechanical perspective, helical double plating may be considered a useful alternative to straight double plating, demonstrating ameliorated damping capacities during flexion deformation and safer application as the medial neurovascular structures of the thigh are avoided.
(© 2023 Orthopaedic Research Society.)
Databáze: MEDLINE
Externí odkaz: