PLACING A THREADED PLUG IN THE HOLE OF A LOCKING PLATE AT THE FRACTURE LEVEL CAN INCREASE THE RESISTANCE OF THE PLATE:A BIOMECHANICAL STUDY
Objectives: This study aimed to evaluate whether placing a threaded plug in the hole of a locking plate at the fracture level is beneficial for increasing the resistance of the plate.
Methods: This experimental study analyzed load and compression forces in sheep tibia bone models. The following groups were assessed: Group 1 (n = 4), control bone samples; Group 2 (n = 4), samples of screw plate fixation without threaded plug in the hole at the fracture level; and Group 3 (n = 4), samples of screw plate fixation with a threaded plug in the hole at the fracture level. Elastic force, bending moment, elastic compression, and rigidity were evaluated using a three-point bending test.
Results: Group 1 showed the greatest elastic force and the least amount of compression. The rigidity and elastic force were better in Group 3 than in Group 2. The mean elastic force in Group 3 was 22.4% of that in Group 1, whereas the mean elastic force in Group 2 was 19% of that in Group 1. Rigidity in Group 3 was 24.7% of that in Group 1, whereas rigidity in Group 2 was 18.3% of that in Group 1. Improved results were obtained in Group 3 when compared with Group 2.
Conclusions: Our results suggest that placing a threaded plug in the hole of the plate at the fracture level provides additional rigidity and stability by improving resistance to loading forces, but the differences were not statistically significant.
Nassiri M, Macdonald B, O'Byrne JM. Computational modelling of long bone fractures fixed with locking plates-How can the risk of implant failure be reduced? J Orthop. 2013; 10(1):29-37.
Niemeyer P, Südkamp NP. Principles and clinical application of the locking compression plate (LCP). Acta Chir Orthop Traumatol Cech. 2006; 73(4):221-8.
Hebert-Davies J, Laflamme GY, Rouleau D, Canet F, Sandman E, Li A, et al. A biomechanical study comparing polyaxial locking screw mechanisms. Injury. 2013; 44(10):1358-62.
Gardner MJ, Evans JM, Dunbar RP. Failure of fracture plate fixation. J Am Acad Orthop Surg. 2009; 17(10):647-57.
Perren SM, Russenberger M, Steinemann S, Müller ME, Allgöwer M. A dynamic compression plate. Acta Orthop Scand Suppl. 1969; 125:31-41.
Kanchanomai C, Phiphobmongkol V, Muanjan P. Fatigue failure of an orthopedic implant-A locking compression plate. Eng Fail Anal. 2008; 15(5):521-30.
Wagner M. General principles for the clinical use of the LCP. Injury. 2003; 34(Suppl 2):B31-42.
Marcomini JB, Baptista CA, Pascon JP, Teixeira RL, Reis FP. Investigation of a fatigue failure in a stainless steel femoral plate. J Mech Behav Biomed Mater. 2014; 38:52-8.
Sommer C, Babst R, Müller M, Hanson B. Locking compression plate loosening and plate breakage: a report of four cases. J Orthop Trauma. 2004; 18(8):571-7.
Gere JM, Timoshenko SP. Stress concentrations. In: Gere JM, Timoshenko SP, eds. Mechanics of Materials, 3rd ed. Boston: PWS; 1990:119-25.
Halldin A, Jinno Y, Galli S, Ander M, Jacobsson M, Jimbo R. Implant stability and bone remodeling up to 84 days of implantation with an initial static strain. An in vivo and theoretical investigation. Clin Oral Implants Res. 2016; 27(10):1310-16.
Zacchetti G, Wiskott A, Cugnoni J, Botsis J, Ammann P. External mechanical microstimuli modulate the osseointegration of titanium implants in rat tibiae. Biomed Res Int. 2013; 2013:234093.
Piccinini M, Cugnoni J, Botsis J, Ammann P, Wiskott A. Influence of gait loads on implant integration in rat tibiae: experimental and numerical analysis. J Biomech. 2014; 47(13):3255-63.
Bellapianta J, Dow K, Pallotta NA, Hospodar PP, Uh RL, Ledet EH. Threaded screw head inserts improve locking plate biomechanical properties. J Orthop Trauma. 2011; 25(2):65-71.
Eichinger JK, Herzog JP, Arrington ED. Analysis of the mechanical properties of locking plates with and without screw hole inserts. Orthopedics. 2011; 34(1):19.
Tompkins M, Paller DJ, Moore DC, Crisco JJ, Terek RM. Locking buttons increase fatigue life of locking plates in a segmental bone defect model. Clin Orthop Relat Res. 2013; 471(3):1039-44.
- There are currently no refbacks.
Copyright (c) 2018 gökhan ragıp ulusoy, Ali Bilge, Yavuz Akalın, Metin Akıncı, Şahin Ermutlu
This work is licensed under a Creative Commons Attribution 4.0 International License.