Biomechanical comparison of fixed-angle volar plate versus fixed-angle volar plate plus fragment-specific fixation in a cadaveric distal radius fracture model. J Hand Surg Am 2007 Feb;32(2):194-9
Date
02/06/2007Pubmed ID
17275594DOI
10.1016/j.jhsa.2006.12.003Scopus ID
2-s2.0-33846624729 (requires institutional sign-in at Scopus site) 30 CitationsAbstract
PURPOSE: To test the hypothesis that combining orthogonal fragment-specific fixation with volar fixed-angle fixation provides markedly higher interfragment stability and construct strength compared with volar fixed-angle fixation alone.
METHODS: Eight matched pairs of fresh cadaveric hand and forearm specimens were potted upright in cement. Flexor and extensor tendons were isolated at insertion sites and sutured into a looped bundle for loading in flexion and extension, respectively (up to 61 N). Osteotomies to simulate an AO type C2, 3-part fracture pattern were created with a saw. One randomized specimen from each pair received a locking volar plate and a radial pin plate (VP+PP), and the other received a locking volar plate only (VP). The relative angular displacements between the radial, ulnar, and proximal fragments were obtained with a motion analysis system. After stability tests, specimens were compressed to failure in a wrist-extended position on a material testing machine. Paired t tests were used to compare the interfragment displacement, construct stiffness, and strength between the 2 groups.
RESULTS: Comparing fragment displacement in the VP+PP and VP groups showed that with flexion-extension and radial-ulnar deviation, distal fragment displacement was reduced to a statistically significant degree. The VP+PP group also showed higher failure strength and construct rigidity than the VP group.
CONCLUSIONS: In a simulated cadaveric model of the distal radius intra-articular fracture, the combined technique of fragment-specific plating with volar fixed-angle fixation alone provides superior biomechanical strength and stability over the volar fixed-angle fixation alone.
Author List
Grindel SI, Wang M, Gerlach M, McGrady LM, Brown SAuthors
Steven I. Grindel MD Professor in the Orthopaedic Surgery department at Medical College of WisconsinMei Wang PhD Associate Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Bone Plates
Cadaver
Fracture Fixation, Internal
Humans
Materials Testing
Middle Aged
Prosthesis Design
Radius Fractures
Weight-Bearing
