Comparison of a 2.7-mm and 3.5-mm locking compression plate for ulnar fractures: a biomechanical evaluation
Abstract. Objectives:. Implant prominence after ulnar fracture fixation may be mitigated by the use of lower profile plates. The biomechanical strength and stability of 2.7-mm and 3.5-mm locking compression plates for fixation were compared. Methods:. Two fracture conditions, transverse (N = 10) and...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-09-01
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| Series: | OTA International |
| Online Access: | http://journals.lww.com/10.1097/OI9.0000000000000278 |
| _version_ | 1797732710553223168 |
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| author | Jenna M. Wahbeh, MS Benjamin V. Kelley, MD Cyrus Shokoohi, BS Sang-Hyun Park, PhD Sai K. Devana, MD Edward Ebramzadeh, PhD Sophia N. Sangiorgio, PhD Devon M. Jeffcoat, MD |
| author_facet | Jenna M. Wahbeh, MS Benjamin V. Kelley, MD Cyrus Shokoohi, BS Sang-Hyun Park, PhD Sai K. Devana, MD Edward Ebramzadeh, PhD Sophia N. Sangiorgio, PhD Devon M. Jeffcoat, MD |
| author_sort | Jenna M. Wahbeh, MS |
| collection | DOAJ |
| description | Abstract. Objectives:. Implant prominence after ulnar fracture fixation may be mitigated by the use of lower profile plates. The biomechanical strength and stability of 2.7-mm and 3.5-mm locking compression plates for fixation were compared.
Methods:. Two fracture conditions, transverse (N = 10) and oblique (N = 10), were evaluated in an in vitro study. Half of the specimens for each condition were fixed with 2.7-mm plates and the other half with 3.5-mm plates, all fixed with conventional dynamic compression mechanisms. Specimens were loaded under ±2 Nm of cyclic axial torsion, then under 10 Nm of cyclic cantilever bending, and bending to failure. Interfragmentary motion and strain were analyzed to determine construct stability as a function of fracture pattern and plate size.
Results:. Interfragmentary motion was significantly larger in all constructs fixed with 2.7-mm plates, compared with 3.5-mm plates (P < 0.01). The 2.7-mm constructs with transverse fractures had the greatest motion, ranging between 5° and 10° under axial rotation and 5.0–6.0 mm under bending. Motions were the lowest for 3.5-mm constructs with oblique fractures, ranging between 3.2 and 4.2 mm under bending and 2°–3.5° for axial rotation. For oblique fractures, the bending moment at ultimate failure was 31.4 ± 3.6 Nm for the 2.7-mm constructs and 10.0 ± 1.9 Nm for 3.5-mm constructs (P < 0.01). Similarly, for transverse fractures, the bending moment was 17.9 ± 4.0 Nm for the 2.7-mm constructs and 9.7 ± 1.3 Nm for the 3.5-mm constructs (P < 0.01).
Conclusions:. Although 3.5-mm plates were more effective at reducing fracture motion, they were consistently associated with refracture at the distal-most screw hole under load to failure. By contrast, 2.7-mm plates plastically deformed despite excessive loads, potentially avoiding a subsequent fracture.
Level of Evidence:. Level V. |
| first_indexed | 2024-03-12T12:18:28Z |
| format | Article |
| id | doaj.art-30ae9c56b2a242878d0f8719a45062cb |
| institution | Directory Open Access Journal |
| issn | 2574-2167 |
| language | English |
| last_indexed | 2024-03-12T12:18:28Z |
| publishDate | 2023-09-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | OTA International |
| spelling | doaj.art-30ae9c56b2a242878d0f8719a45062cb2023-08-30T06:17:40ZengWolters KluwerOTA International2574-21672023-09-016310.1097/OI9.0000000000000278OI90000000000000278Comparison of a 2.7-mm and 3.5-mm locking compression plate for ulnar fractures: a biomechanical evaluationJenna M. Wahbeh, MS0Benjamin V. Kelley, MD1Cyrus Shokoohi, BS2Sang-Hyun Park, PhD3Sai K. Devana, MD4Edward Ebramzadeh, PhD5Sophia N. Sangiorgio, PhD6Devon M. Jeffcoat, MD7a The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Luskin Orthopaedic Institute for Children in Alliance with UCLA, Los Angeles, CAc University of California, Los Angeles, Department of Orthopaedic Surgery, Los Angeles, CAb University of California, Los Angeles, Department of Bioengineering, Los Angeles, CAa The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Luskin Orthopaedic Institute for Children in Alliance with UCLA, Los Angeles, CAc University of California, Los Angeles, Department of Orthopaedic Surgery, Los Angeles, CAa The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Luskin Orthopaedic Institute for Children in Alliance with UCLA, Los Angeles, CAa The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Luskin Orthopaedic Institute for Children in Alliance with UCLA, Los Angeles, CAc University of California, Los Angeles, Department of Orthopaedic Surgery, Los Angeles, CAAbstract. Objectives:. Implant prominence after ulnar fracture fixation may be mitigated by the use of lower profile plates. The biomechanical strength and stability of 2.7-mm and 3.5-mm locking compression plates for fixation were compared. Methods:. Two fracture conditions, transverse (N = 10) and oblique (N = 10), were evaluated in an in vitro study. Half of the specimens for each condition were fixed with 2.7-mm plates and the other half with 3.5-mm plates, all fixed with conventional dynamic compression mechanisms. Specimens were loaded under ±2 Nm of cyclic axial torsion, then under 10 Nm of cyclic cantilever bending, and bending to failure. Interfragmentary motion and strain were analyzed to determine construct stability as a function of fracture pattern and plate size. Results:. Interfragmentary motion was significantly larger in all constructs fixed with 2.7-mm plates, compared with 3.5-mm plates (P < 0.01). The 2.7-mm constructs with transverse fractures had the greatest motion, ranging between 5° and 10° under axial rotation and 5.0–6.0 mm under bending. Motions were the lowest for 3.5-mm constructs with oblique fractures, ranging between 3.2 and 4.2 mm under bending and 2°–3.5° for axial rotation. For oblique fractures, the bending moment at ultimate failure was 31.4 ± 3.6 Nm for the 2.7-mm constructs and 10.0 ± 1.9 Nm for 3.5-mm constructs (P < 0.01). Similarly, for transverse fractures, the bending moment was 17.9 ± 4.0 Nm for the 2.7-mm constructs and 9.7 ± 1.3 Nm for the 3.5-mm constructs (P < 0.01). Conclusions:. Although 3.5-mm plates were more effective at reducing fracture motion, they were consistently associated with refracture at the distal-most screw hole under load to failure. By contrast, 2.7-mm plates plastically deformed despite excessive loads, potentially avoiding a subsequent fracture. Level of Evidence:. Level V.http://journals.lww.com/10.1097/OI9.0000000000000278 |
| spellingShingle | Jenna M. Wahbeh, MS Benjamin V. Kelley, MD Cyrus Shokoohi, BS Sang-Hyun Park, PhD Sai K. Devana, MD Edward Ebramzadeh, PhD Sophia N. Sangiorgio, PhD Devon M. Jeffcoat, MD Comparison of a 2.7-mm and 3.5-mm locking compression plate for ulnar fractures: a biomechanical evaluation OTA International |
| title | Comparison of a 2.7-mm and 3.5-mm locking compression plate for ulnar fractures: a biomechanical evaluation |
| title_full | Comparison of a 2.7-mm and 3.5-mm locking compression plate for ulnar fractures: a biomechanical evaluation |
| title_fullStr | Comparison of a 2.7-mm and 3.5-mm locking compression plate for ulnar fractures: a biomechanical evaluation |
| title_full_unstemmed | Comparison of a 2.7-mm and 3.5-mm locking compression plate for ulnar fractures: a biomechanical evaluation |
| title_short | Comparison of a 2.7-mm and 3.5-mm locking compression plate for ulnar fractures: a biomechanical evaluation |
| title_sort | comparison of a 2 7 mm and 3 5 mm locking compression plate for ulnar fractures a biomechanical evaluation |
| url | http://journals.lww.com/10.1097/OI9.0000000000000278 |
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