Variable fixation promotes callus formation: an experimental study on transverse tibial osteotomies stabilized with locking plates
Autor: | Karina Klein, Katrin Planzer, Pascal Behm, Stephen J. Ferguson, Michael Plecko, Dirk Wähnert, Stefano Brianza, Brigitte von Rechenberg, Vincent A. Stadelmann |
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Přispěvatelé: | University of Zurich, Brianza, Stefano |
Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
lcsh:Diseases of the musculoskeletal system
medicine.medical_treatment Non-unions 2745 Rheumatology Bone Screws Fracture healing Osteotomy Locking plate Variable fixation Fracture Fixation Internal 0302 clinical medicine Medicine Orthopedics and Sports Medicine 030212 general & internal medicine Bony Callus Fixation (histology) Orthodontics 030222 orthopedics Fracture complications food and beverages musculoskeletal system 10226 Department of Molecular Mechanisms of Disease Biomechanical Phenomena Variable fixation locking screw Female VFLS Bone Plates Research Article medicine.medical_specialty Callus formation Bone healing Delayed unions 03 medical and health sciences 2732 Orthopedics and Sports Medicine Rheumatology Fracture dynamization Animals Humans Tibia Sheep business.industry fungi Tibial Fractures Callus Orthopedic surgery 570 Life sciences biology lcsh:RC925-935 business |
Zdroj: | BMC Musculoskeletal Disorders BMC Musculoskeletal Disorders, Vol 21, Iss 1, Pp 1-13 (2020) BMC Musculoskeletal Disorders, 21 (1) |
ISSN: | 1471-2474 |
DOI: | 10.5167/uzh-201738 |
Popis: | Background A new locking screw technology, named variable fixation, has been developed aiming at promoting bone callus formation providing initial rigid fixation followed by progressive fracture gap dynamisation. In this study, we compared bone callus formation in osteotomies stabilized with standard locking fixation against that of osteotomies stabilized with variable fixation in an established tibia ovine model. Methods A 3 mm tibial transverse osteotomy gap was stabilized in three groups of six female sheep each with a locking plate and either 1) standard fixation in both segments (group LS) or 2) variable fixation in the proximal and standard fixation in the distal bone segment (group VFLS3) or 3) variable fixation in both segments (group VFLS6). The implantation site and fracture healing were compared between groups by means of radiologic, micro tomographic, biomechanical, and histological investigations. Results Compared to LS callus, VFLS3 callus was 40% larger and about 3% denser, while VFLS6 callus was 93% larger and its density about 7.2% lower. VFLS3 showed 65% and VFLS6 163% larger amount of callus at the cis-cortex. There wasn’t a significant difference in the amount of callus at the cis and trans-cortex in groups featuring variable fixation only. Investigated biomechanical variables were not significantly different among groups and histology showed comparable good healing in all groups. Tissues adjacent to the implants did not show any alteration of the normal structure in all groups. Conclusions Variable fixation promoted the formation of a larger amount of bone callus, equally distributed at the cis and trans cortices. The histological and biomechanical properties of the variable fixation callus were equivalent to those of the standard fixation callus. The magnitude of variable fixation had a biological effect on the formation of bone callus. At the implantation site, the usage of variable fixation did not raise additional concerns with respect to standard fixation. The formation of a larger amount of mature callus suggests that fractures treated with variable fixation might have a higher probability to bridge the fracture gap. The conditions where its usage can be most beneficial for patients needs to be clinically defined. BMC Musculoskeletal Disorders, 21 (1) ISSN:1471-2474 |
Databáze: | OpenAIRE |
Externí odkaz: |
Abstrakt: | Background A new locking screw technology, named variable fixation, has been developed aiming at promoting bone callus formation providing initial rigid fixation followed by progressive fracture gap dynamisation. In this study, we compared bone callus formation in osteotomies stabilized with standard locking fixation against that of osteotomies stabilized with variable fixation in an established tibia ovine model. Methods A 3 mm tibial transverse osteotomy gap was stabilized in three groups of six female sheep each with a locking plate and either 1) standard fixation in both segments (group LS) or 2) variable fixation in the proximal and standard fixation in the distal bone segment (group VFLS3) or 3) variable fixation in both segments (group VFLS6). The implantation site and fracture healing were compared between groups by means of radiologic, micro tomographic, biomechanical, and histological investigations. Results Compared to LS callus, VFLS3 callus was 40% larger and about 3% denser, while VFLS6 callus was 93% larger and its density about 7.2% lower. VFLS3 showed 65% and VFLS6 163% larger amount of callus at the cis-cortex. There wasn’t a significant difference in the amount of callus at the cis and trans-cortex in groups featuring variable fixation only. Investigated biomechanical variables were not significantly different among groups and histology showed comparable good healing in all groups. Tissues adjacent to the implants did not show any alteration of the normal structure in all groups. Conclusions Variable fixation promoted the formation of a larger amount of bone callus, equally distributed at the cis and trans cortices. The histological and biomechanical properties of the variable fixation callus were equivalent to those of the standard fixation callus. The magnitude of variable fixation had a biological effect on the formation of bone callus. At the implantation site, the usage of variable fixation did not raise additional concerns with respect to standard fixation. The formation of a larger amount of mature callus suggests that fractures treated with variable fixation might have a higher probability to bridge the fracture gap. The conditions where its usage can be most beneficial for patients needs to be clinically defined.<br />BMC Musculoskeletal Disorders, 21 (1)<br />ISSN:1471-2474 |
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ISSN: | 14712474 |
DOI: | 10.5167/uzh-201738 |