Supplementation of Lateral Locked Plating for Distal Femur Fractures: A Biomechanical Study
| Autor: | Miguel A. Diaz, Brett Barrick, Kyle Stoops, Hassan R. Mir, Philip B Fontenot, Brandon G. Santoni |
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| Rok vydání: | 2019 |
| Předmět: |
Models
Anatomic Group ii Locked plating Bone Nails medicine.disease_cause Models Biological law.invention Weight-bearing Intramedullary rod Weight-Bearing 03 medical and health sciences Distal femur Fracture Fixation Internal 0302 clinical medicine law Fracture fixation Bone plate medicine Humans Orthopedics and Sports Medicine Fractures Comminuted Fixation (histology) Orthodontics 030222 orthopedics business.industry 030208 emergency & critical care medicine General Medicine Equipment Failure Analysis Surgery business Bone Plates Femoral Fractures |
| Zdroj: | Journal of orthopaedic trauma. 33(12) |
| ISSN: | 1531-2291 |
| Popis: | OBJECTIVES To investigate the biomechanical properties of a lateral locked plate alone or in combination with a supplemental medial plate or an intramedullary nail (IMN). METHODS Intra-articular distal femur fractures with metaphyseal comminution (OTA/AO 33-C) were simulated with a standardized model in 28 synthetic femora and divided into 4 groups. Group I was instrumented with a 4.5-mm lateral locked distal femoral plate alone, group II with a lateral locked plate plus a low-profile precontoured 3.5-mm medial distal tibial plate, group III with a lateral locked plate plus a medial 3.5-mm reconstruction plate, and group IV with a lateral locked plate plus a retrograde IMN. Specimens were then axially loaded and cycled to failure or runout. Outcomes of interest were baseline stiffness, survivability, and cycles to failure. RESULTS Groups III and IV have a significantly higher baseline stiffness (P < 0.001) when compared with groups I and II. Furthermore, groups III and IV had a higher max load to failure (P < 0.01) when compared with groups I and II. The survivability in groups III and IV was 71% and 100%, respectively, while no specimens in group I or II survived maximum loading. There was no significant difference between group III and IV regarding stiffness, survivability, and cycles to failure. CONCLUSION When considering fixation for intra-articular distal femur fractures with metaphyseal comminution (OTA/AO 33-C), we found that supplementation of a lateral locked plate with a medial plate or an IMN to be biomechanically superior to lateral locked plating alone regarding stiffness, survivability, and cycles to failure. A low-profile precontoured plate did not add significantly to the construct stiffness in this study. |
| Databáze: | OpenAIRE |
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