Additional fixation of medial plate over the unstable lateral locked plating of distal femur fractures: A biomechanical study |
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| Affiliation: | 1. Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria;2. AUVA Trauma Hospital Styria, Göstinger Straße 24, 8020 Graz, Austria;3. Chair of Macroscopic and Clinical Anatomy, Medical University of Graz, Harrachgasse 21, 8010 Graz, Austria;4. Department of Dental Medicine and Oral Health, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria;5. Trauma and Orthopaedics Department, University Hospital Merkur, Zagreb, Croatia;6. Trauma and Orthopaedics Department, Medical University Hospital LKH Graz, Austria;1. Department of Orthopaedic Surgery Indiana University School of Medicine, Indianapolis, Indiana;2. Indiana Orthopaedic Hospital–OrthoIndy, Indianapolis, Indiana;1. Department of Mechanical Engineering, McMaster University, Hamilton, Ontario, Canada;2. Department of Surgery, Division of Orthopaedics, McMaster University, Hamilton, Ontario, Canada;3. McMaster School of Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada |
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| Abstract: | IntroductionLateral locked plating is a standard treatment option for distal femur fractures. However, the unstable conditions after lateral locked plating are increasing. The objective of this study was to investigate the biomechanical strength of additional medial plate fixation over the unstable lateral locked plating of distal femur fractures.Materials and methodsA distal femur fracture model (AO/OTA 33-A3) was created with osteotomies in the composite femur. Three study groups consisting of 6 specimens each were created for single-side lateral locked plating with 6 distal locking screws (LP-6), single-side lateral locked plating with 4 distal locking screws (LP-4), and additional medial locked plating on LP-4 construct (DP-4). A compressive axial load (10 mm/min) was applied in the failure test. Mode of failure, load to failure, and ultimate displacement were documented.ResultsAll single-side lateral locked plating (LP-4 and LP-6) showed plate bending at the fracture gap, while none of the DP-4 showed plate bending at the fracture gap. Load to failure of DP-4 (mean 5522 N) was 17.1% greater than that of LP-6 (mean 4713.3 N, p < 0.05) and 29.2% greater than that of LP-4 (mean 4273.2 N, p < 0.05). Ultimate displacement of DP-4 (mean 5.6 mm) was significantly lower than that of LP-6 (mean 8.8 mm, p < 0.05) and LP-4 (mean 9.1 mm, p < 0.05).ConclusionsAdditional fixation of medial plate significantly increased the fracture stability in distal femur fractures fixed with the lateral locked plating. Especially in the clinical situations where sufficient stability cannot be provided at the distal segment, the medial plate may be considered as a useful biomechanical solution to obtain adequate stability for fracture healing. |
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| Keywords: | Distal femur fracture Lateral locked plate Double plate Biomechanical study |
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