Mechanical properties of 18 different AO bone plates and the clamp-rod internal fixation system tested on a gap model construct.

OBJECTIVE: To compare the stiffness and strength of AO bone plates (DCP, LC-DCP, VCP, RCP, and LP) and the Clamp-Rod Internal Fixation System (CRIF). Study design: In vitro. Sample size: 12 individual implants of 18 plate dimensions and four sizes of CRIF, each corresponding to 2.0, 2.4/2.7, 3.5, or 4.5 mm screw sizes. METHODS: Implant-constructs of each plate and CRIF were created using Canevasit rods as a bone substitute in an unstable gap fracture model. Six implant-constructs of each type were tested under single cycle four-point bending loading, and six were tested under single cycle torsional loading until permanent plastic deformation occurred. RESULTS: Torsional stiffness and yield load of the DCP were always significantly greater than the CRIF within the same group. Bending properties of the 2.0 DCP were not significantly different to the 2.0 CRIF. The 2.7 DCP had significantly higher bending values than the 2.7 CRIF. The bending stiffness of the 3.5 DCP and 4.5 DCP was significantly less than their CRIF counterparts. While the bending yield load of the 3.5 DCP was significantly greater than the 3.5 CRIF, the bending yield load of the 4.5 DCP was significantly less than the 4.5 CRIF. CONCLUSION: A weakness was found in the torsional resistance of the CRIF constructs compared to the DCP constructs. CLINICAL SIGNIFICANCE: Bone holding power and applied screw torque should be considered when using the CRIF system in clinical application.     

In vitro biomechanical comparison of dynamic compression plates with a rough contact surface and a polished contact surface for fixation of osteotomized equine third metacarpal bones

Objectives: To compare the number of cycles to failure of 4.5 mm broad dynamic compression plates (DCP), 4.5 mm broad limited‐contact dynamic compression plates (4.5‐LC‐DCP), and 5.5 mm broad limited‐contact dynamic compression plates (5.5‐LC‐DCP) having a rough (denoted by a prefix R‐) versus a standard smooth contact surface for the fixation of osteotomized equine 3rd metacarpal (MC3) bones. Study Design: Experimental. Animal Population: Fifteen pairs of adult equine cadaveric MC3 bones. Methods: Fifteen pairs of equine MC3 were divided into 3 test groups (5 pairs each) for comparison of (1) R‐DCP fixation with DCP fixation, (2) R‐4.5‐LC‐DCP fixation with 4.5‐LC‐DCP fixation, and (3) R‐5.5‐LC‐DCP fixation with 5.5‐LC‐DCP fixation to repair osteotomized equine MC3 bones under palmarodorsal 4‐point bending cyclic fatigue testing. For each group an 8‐hole plate with rough contact surface was applied to the dorsal surface of one randomly selected bone from each pair and a corresponding 8‐hole plate with smooth contact surface was applied dorsally to the contralateral bone from each pair. All plates and screws were applied using standard ASIF techniques. All MC3 bones had mid‐diaphyseal osteotomies. Mean number of cycles to failure for each method were compared using a paired t‐test within each group. Significance was set at P<.05. Results: Mean cycles to failure ± standard deviation was significantly greater for the R‐DCP fixation (230,025 ± 23,129) compared with the DCP fixation (103,451 ± 14,556), for the R‐4.5‐LC‐DCP fixation (99,237 ± 14,390) compared with the 4.5‐LC‐DCP fixation (46,464 ± 6325) and for the R‐5.5‐LC‐DCP fixation (65,113 ± 7796) compared with the 5.5‐LC‐DCP fixation (34,224 ± 3835). Conclusion: For the fixation of osteotomized MC3 bones, the constructs with plates having rough contact surface were superior to the corresponding constructs with plates having standard smooth contact surfaces in resisting cyclic fatigue under palmarodorsal 4‐point bending.     

Mechanical Comparison of 3.5 mm Broad Dynamic Compression Plate,Broad Limited‐Contact Dynamic Compression Plate,and Narrow Locking Compression Plate Systems Using Interfragmentary Gap Models

Objectives— To compare (1) pullout properties between 3.5 mm cortical and locking screws, and (2) mechanical properties and gap displacements between the 3.5 mm broad limited‐contact dynamic compression plate (LC‐DCP), broad dynamic compression plate (DCP), and narrow locking compression plate (LCP), during axial loading of plate‐stabilized diaphyseal fragments with an interfragmentary gap. Study Design— In vitro mechanical testing of implanted polyurethane foam (PUF) hollow cylinders that simulated compact or osteopenic diaphyseal bone. Sample Population— (1) Five cortical and locking screws and (2) 4 PUF‐plate constructs for each plate type; using high‐ and low‐density (0.8 and 0.32 g/cm³) cylinders. Methods— (1) Screws were completely extracted at 5 mm/min. (2) Plated constructs were axially compressed at 300 N/s for 10 cycles from 5 to 355 N to determine gap displacement during physiologic loading, followed by single cycle increasing load to failure. Results— Pullout properties were not different between screw types. All plate constructs had yield loads over 3 times trotting loads. Gap closure occurred with LC‐DCP and DCP constructs, but not LCP constructs. LCP construct properties were most similar to LC‐DCP and DCP construct properties in the low‐density model. Conclusion— All plate systems sustained physiologic limb loads. Only LCP constructs maintained some gap integrity, although LC‐DCP and DCP screws were placed in neutral position. Clinical Relevance— The LCP system is more likely than LC‐DCP and DCP systems, with neutrally positioned screws, to maintain a planned interfragmentary gap, although gap strains range from 0% to 15% across the 2 mm gap during a trot load.     

Mechanical testing of 3.5 mm locking and non-locking bone plates

Locking plate technologies are being developed in order to provide the surgeon with advantages over previous bone plate systems (both locking and non-locking). Locking plate systems possess inherent biological advantages in fracture fixation by preserving the periosteal blood supply, serving as internal fixators. It is important to consider the strength of each orthopaedic implant as an important selection criterion while utilizing the reported advantages of locking plate systems to prevent catastrophic fracture failure. Mechanical testing of orthopaedic implants is a common method used to provide a surgeon with insight on mechanical capabilities, as well as to form a standardized method of plate comparison. The purpose of this study was to demonstrate and to quantify observed differences in the bending strength between the LCP (Limited Contact Plate), LC-DCP, 3.5 mm Broad LC-DCP (Limited Contact Dynamic Compression Plate), and SOP (String of Pearls) orthopaedic bone plates. The study design followed the ASTM standard test method for static bending properties of metallic bone plates, which is designed to measure mechanical properties of bone plates subjected to bending, the most common loading encountered in vivo. Single cycle four point bending was performed on each orthopaedic implant. The area moment of inertia, bending stiffness, bending strength, and bending structural stiffness were calculated for each implant. The results of this study demonstrated significant differences (p<0.001) in bending strength and stiffness between the four orthopaedic implants (3.5 Broad LC-DCP>SOP>LCP=LC-DCP). The 3.5 mm LCP should be expected to provide in vivo strength and stiffness similar to a comparable LC-DCP. The SOP should provide strength and stiffness that is greater than a comparable LC-DCP but less than a 3.5 mm Broad LC-DCP.     

Arthrodesis of the Equine Proximal Interphalangeal Joint: A Biomechanical Comparison of Two 7-Hole 3.5-mm Broad and Two 5-hole 4.5-mm Narrow Dynamic Compression Plates

OBJECTIVE: To compare the biomechanical characteristics and mode of failure of two different dynamic compression plate (DCP) techniques for proximal interphalangeal joint (PIPJ) arthrodesis in horses. STUDY DESIGN: Randomized block-design blocking on horse (1-5), method of fixation (two 7-hole, 3.5-mm broad DCP vs two 5-hole, 4.5-mm narrow DCP), side (left, right), and end (front, hind). Constructs were loaded to failure in 3-point bending in a dorsal-to-palmar (plantar) direction. SAMPLE POPULATION: Ten paired limbs from 5 equine cadavers. METHODS: Two 7-hole, 3.5-mm broad dynamic compression plates (bDCP) were used in 1 limb of a pair, and two 5-hole 4.5-mm narrow dynamic compression plates (nDCP) were used on the contralateral limb. Plates were positioned abaxially across the dorsomedial and dorsolateral aspect of the PIPJ. Arthrodesis constructs were loaded (19 mm/s) in 3-point bending in a dorsal-to-palmar (plantar) direction using a materials-testing machine. Composite stiffness, yield point, and maximal bending moment at failure were obtained from bending moment-angular deformation curves. Data were analyzed using ANOVA, X(2) analysis, and Fisher's exact tests; the power of the test was calculated when differences were not significant. RESULTS: There were no significant differences in composite stiffness (P >.05; power = 0.8 @ delta = 21.9%), yield point (P >.05; power = 0.8 @ delta = 34.4%), or maximal bending moment (P >.05; power = 0.8 @ delta = 17.8%) between the two fixation techniques. For bDCP constructs, 11% (15 of 140) of the 3.5-mm screws were damaged; 7 of the screw heads pulled through plates where the plates bent, 1 screw head broke off, and 7 screws were bent or pulled out of the phalanx. For nDCP constructs, 8% (8 of 100) of the 4.5-mm screws were damaged; 1 screw head pulled through a plate, 1 screw head broke off, and 6 screws were bent or pulled out of the phalanx. CONCLUSIONS: There were no biomechanical or failure differences between bDCP and nDCP fixation of the PIPJ in horses when evaluated in single-cycle 3-point bending to failure. CLINICAL RELEVANCE: There is no biomechanical advantage to the use of two 7-hole, 3.5-mm bDCP in equine proximal interphalangeal arthrodesis compared with two 5-hole, 4.5-mm nDCP. Two 5-hole, 4.5-mm nDCP may be easier to place, whereas two 7-hole, 3.5-mm bDCP may provide more versatility in fracture repair.     

An In Vitro Biomechanical Investigation of the Mechanical Properties of Dynamic Compression Plated Osteotomized Adult Equine Tibiae

Objective — To determine the monotonic mechanical properties of osteotomized adult equine tibiae stabilized with two dynamic compression plates (DCP) and to compare the mechanical properties with those of intact tibiae and in vivo loads.
Study Design — The compressive, bending, and torsional mechanical properties of plated and intact tibiae were assessed in vitro.
Animals or Sample Population — Twelve pairs of adult equine tibiae.
Methods — Tibiae were loaded in axial compression, craniocaudal 3-point bending, or torsion in external rotation in a single cycle to failure. Mechanical properties were determined from load-displacement data.
Results — Compared to intact tibiae, the mean yield load, failure load and stiffness of plated tibiae were significantly lower ( P <.05) (compression and torsion); and the mean yield and failure bending moments, and bending stiffness, of the plated tibiae were lower ( P <.075 for yield), or significantly lower, respectively. The mean compression and bending yield loads for plated tibiae were greater than in vivo loads. The mean torsional yield load for plated tibiae approximated the torsional load determined for the adult horse at a walk.
Conclusions — Simple, anatomically reduced, DCP plated tibiae should have adequate strength to withstand immediate, postoperative in vivo compressive loads and bending moments placed on the tibia in vivo during immediate postoperative activities, however, may not have adequate torsional strength during immediate postoperative weight-bearing at a walk.
Clinical Relevance — Additional supportive methods, to decrease torsional loads, may be beneficial in maintaining stability of plate repaired tibiae during recovery from anesthesia and postoperative healing.     

An in vitro biomechanical comparison of interlocking nail constructs and double plating for fixation of diaphyseal femur fractures in immature horses

OBJECTIVE: To compare the biomechanical properties of intact immature horse femurs and 3 stabilization methods in ostectomized femurs. Animal or SAMPLE POPULATION: Eighteen pairs of femurs from immature horses aged 1 to 15 months, and weighing 68 to 236 kg. METHODS: Thirty-four immature horse femurs were randomly assigned to 1 of 5 test groups: 1) interlocking intramedullary nail (IIN) (n = 6); 2) IIN with a cranial dynamic compression plate (I/DCP) (n = 6); 3) 2 dynamic compression plates (2DCP) (n = 8); 4) intact femurs tested to failure in lateromedial (LM) bending (n = 6); and 5) intact femurs tested to failure in caudocranial (CaCr) bending (n = 8). Mid-diaphyseal ostectomies (1 cm) were performed in all fixation constructs. Biomechanical testing consisted of 4 nondestructive tests: CaCr bending, LM bending, compression, and torsion, followed by bending to failure. All groups were tested to failure in LM bending with the exception of 1 group of intact femurs tested to failure in CaCr bending. Stiffness and failure properties were compared among groups. RESULTS: The 2DCP-femur construct had greater structural stiffness in nondestructive bending than the IIN-femur construct in either LM or CaCr bending, and the I/DCP-femur construct in LM bending. Only the I/DCP and 2DCP fixations were similar to intact bone in nondestructive-bending tests. In addition, the 2DCP-femur construct had greater structural and gap torsional stiffness than the I/DCP-femur construct, and greater gap torsional stiffness than the IIN-femur construct. However, all of the fixation methods tested, including the 2DCP-femur construct, had lower structural stiffness in torsional loading compared with intact bone. No significant differences in structural stiffness were found between intact bones and femur constructs tested nondestructively in compression. In resistance to LM bending to failure, the 2DCP-femur construct was superior to the IIN-femur construct, yet similar to the I/DCP-femur construct. Also, evaluation of yield and failure loads revealed no significant differences between intact bone and any of the femur constructs tested to failure in LM bending. CONCLUSIONS: In general, the 2DCP-femur construct provided superior strength and stiffness compared with the IIN and I/DCP-femur constructs under bending and torsion. CLINICAL RELEVANCE: Double plating of diaphyseal comminuted femoral fractures in immature horses may be the best method of repair, because in general, it provides the greatest strength and stiffness in bending and torsion.     

In vitro biomechanical comparison of locking compression plate fixation and limited-contact dynamic compression plate fixation of osteotomized equine third metacarpal bones

Objective— To compare monotonic biomechanical properties and fatigue life of a broad locking compression plate (LCP) fixation with a broad limited contact dynamic compression plate (LC‐DCP) fixation to repair osteotomized equine third metacarpal (MC3) bones. Study Design— In vitro biomechanical testing of paired cadaveric equine MC3 with a mid‐diaphyseal osteotomy, stabilized by 1 of 2 methods for fracture fixation. Animal Population— Cadaveric adult equine MC3 bones (n=12 pairs). Methods— MC3 were divided into 3 groups (4 pairs each) for: (1) 4‐point bending single cycle to failure testing; (2) 4‐point bending cyclic fatigue testing; and (3) torsional single cycle to failure testing. The 8‐hole, 4.5 mm LCP was applied to the dorsal surface of 1 randomly selected bone from each pair. One 8‐hole, 4.5 mm LC‐DCP) was applied dorsally to the contralateral bone from each pair. All plates and screws were applied using standard ASIF techniques. All MC3 bones had mid‐diaphyseal osteotomies. Mean test variable values for each method were compared using a paired t‐test within each group. Significance was set at P<.05. Results— Mean yield load, yield bending moment, composite rigidity, failure load and failure bending moment, under 4‐point bending, single cycle to failure, of the LCP fixation were significantly greater than those of the LC‐DCP fixation. Mean cycles to failure for 4‐point bending was significantly greater for the LCP fixation compared with LC‐DCP fixation. Mean yield load, mean composite rigidity, and mean failure load under torsional testing, single cycle to failure was significantly greater for the broad LCP fixation compared with the LC‐DCP fixation. Conclusion— The 4.5 mm LCP was superior to the 4.5 mm LC‐DCP in resisting the static overload forces (palmarodorsal 4‐point bending and torsional) and in resisting cyclic fatigue under palmarodorsal 4‐point bending. Clinical Relevance— The results of this in vitro study may provide information to aid in the selection of a biological plate for the repair of equine long bone fractures.     

A Biomechanical Comparison of 7-Hole 3.5 mm Broad and 5-Hole 4.5 mm Narrow Dynamic Compression Plates

Seven-hole 3.5 mm broad and 5-hole 4.5 mm narrow dynamic compression plates were applied to paired canine cadaveric tibias in a stable fracture model. Paired tibias were tested to acute failure in rotation and four-point bending, and to fatigue failure in four-point bending. Resistance to screw pullout was measured for three 3.5 mm cortical screws and two 4.5 mm cortical screws inserted in the configurations of the bone plates. All plate-bone systems failed by fracture of the bone through a screw hole. The 3.5 mm plate-bone system was stronger in acute failure in rotation and in four-point bending. There was no difference in stiffness, and no difference in the number of cycles to failure in fatigue testing. Three 3.5 mm screws had greater resistance to pullout than two 4.5 mm screws. Results indicate that the 7-hole 3.5 mm broad dynamic compression plate has a biomechanical advantage over the 5-hole 4.5 mm narrow dynamic compression plate.     

Assessment of stiffness and strength of 4 different implants available for equine fracture treatment: a study on a 20 degrees oblique long-bone fracture model using a bone substitute

OBJECTIVE: To compare the mechanical properties of 4 stabilization methods for equine long-bone fractures: dynamic compression plate (DCP), limited contact-DCPlate (LC-DCP), locking compression plate (LCP), and the clamp-rod internal fixator (CRIF--formerly VetFix). STUDY DESIGN: In vitro mechanical study. SAMPLE POPULATION: Bone substitute material (24 tubes) was cut at 20 degrees to the long axis of the tube to simulate an oblique mid-shaft fracture. METHODS: Tubes were divided into 4 groups (n=6) and double plated in an orthogonal configuration, with 1 screw of 1 implant being inserted in lag fashion through the "fracture". Thus, the groups were: (1) 2 DCP implants (4.5, broad, 10 holes); (2) 2 LC-DCP implants (5.5, broad, 10 holes); (3) 2 LCP implants (4.5/5.0, broad, 10 holes) and 4 head locking screws/plate; and (4) 2 CRIF (4.5/5.0) and 10 clamps in alternating position left and right of the rod. All constructs were tested in 4-point bending with a quasi-static load until failure. The implant with the interfragmentary screw was always positioned on the tension side of the construct. Force, displacement, and angular displacement at the "fracture" line were determined. Construct stiffness under low and high loads, yield strength, ultimate strength, and maximum angular displacement were determined. RESULTS: None of the implants failed; the strength of the bone substitute was the limiting factor. At low loads, no differences in stiffness were found among groups, but LCP constructs were stiffer than other constructs under high loads (P=.004). Ultimate strength was lowest in the LCP group (P=.01), whereas yield strength was highest for LCP constructs (409 N m, P=.004). CRIF had the lowest yield strength (117 N m, P=.004); no differences in yield strength (250 N m) were found between DCP and LC-DCP constructs. Differences were found for maximum angular displacement at the "fracture" line, between groups: LPC相似文献   

Comparison of double dynamic compression plating versus two configurations of an internal veterinary fixation device: Results of in vitro mechanical testing using a bone substitute

OBJECTIVE: To compare the mechanical properties of 2 configurations of a veterinary fixation system (VFS) for large animal long bones with dynamic compression plating (DCP). SAMPLE POPULATION: Eighteen pairs of Canevasit tubes (Canevasit; Amsler und Frei, Schinznach Dorf, Switzerland) (length, 170 mm; diameter, 47.5 mm; cortex thickness, 10 mm), aligned with a 10-mm gap, and stabilized with 2 DCP or 2 VFS implants. METHODS: Three groups (n = 6) were compared. Group 1 Canevasit tubes were stabilized with two 10-hole, broad 4.5-mm stainless steel DCP applied with both plates centered over the gap, in orthogonal planes parallel to the long axis of the tubes and staggered to allow bicortical fixation with ten 4.5-mm, 52-mm-long cortex screws each. Group 2 tubes were stabilized similarly with 2 VFS implants, each composed of a stainless steel rod (length, 167 mm; diameter, 8 mm), and 10 clamps were applied in alternating fashion left and right on the rod and fixed bicortically with ten 4.5-mm, 52-mm-long, cortex screws. Group 3 tubes were stabilized similarly, but using only 6 clamps/rod. All groups were tested initially in torsion within elastic limits and subsequently in 4-point bending, with 1 implant on the tension side, until gap closure occurred. RESULTS: None of the constructs failed, but all had plastic deformation after 4-point bending. No statistically significant differences were found among the 3 groups in torsional stiffness. Double DCP fixation was significantly stiffer and stronger in 4-point bending, compared with both configurations of double VFS fixation. CONCLUSIONS: The plate design was favored in this study. The VFS system may have to be adapted before further tests are conducted. Test modalities have to be chosen closer to clinical conditions (real bone, cyclic loading, closed gap). CLINICAL RELEVANCE: The veterinary fixation system has not yet proven its advantages for large animal long bone fracture repair. From the pure mechanical point of view, double DCP is the favored method for the treatment mentioned.     

An In Vitro Biomechanical Comparison of Dynamic Condylar Screw Plate Combined with a Dorsal Plate and Double Plate Fixation of Distal Diaphyseal Radial Osteotomies in Adult Horses

Objective— To compare stiffness and strength of a dynamic condylar screw plate combined with dorsal broad dynamic compression plate (DCS–bDCP) fixation with double broad dynamic compression plate (dbDCP) fixation used to repair oblique distal fractures of adult equine radii. Study Design— Experimental. Sample Population— Adult equine radii (n=10 pair). Methods— An unconstrained three‐dimensional loading–measurement system was used to determine stiffness of a 50 mm long intact, and then DCS–bDCP or dbDCP‐plated osteotomized/ostectomized segment of radii when subjected to a nondestructive sequence of compression, torsion, and lateral‐to‐medial (LM), medial‐to‐lateral (ML), cranial‐to‐caudal (CrCa), and caudal‐to‐cranial (CaCr) bending. Uniform load over the entire length of construct identified its weakest characteristics during torsion and LM and CrCa bending to failure. Results— No difference was observed between osteotomized/ostectomized DCS–bDCP and dbDCP construct stiffness for all 6 loading modes, and strength for all 3 failure loads. Ostectomized DCS–bDCP and dbDCP construct stiffness was significantly lower than osteotomized radii, the latter approaching intact for axial, LM, and CrCa bending. Most frequent failure was bone fracture through exit site of a screw located adjacent to osteotomy/ostectomy. Conclusions— DCS–DCP and dbDCP constructs had comparable strength and stiffness when repairing osteotomies/ostectomies in equine adult radius bone. Fracture reduction increased stiffness that approached intact bone for loads that placed the unplated side in compression. Clinical Relevance— DCS–bDCP and dbDCP constructs are comparable in stiffness and strength when applied to oblique distal diaphyseal osteotomies/ostectomies in equine radius bone. However, the DCS's localized effect on distal epiphyseal structure because of additional bone removal remains to be investigated under in vivo articular loading conditions.     

An in vitro biomechanical comparison of a 5.5 mm limited-contact dynamic compression plate fixation with a 4.5 mm limited-contact dynamic compression plate fixation of osteotomized equine third metacarpal bones

Objectives— To compare monotonic biomechanical properties and fatigue life of a 5.5 mm broad limited‐contact dynamic compression plate (5.5‐LC‐DCP) fixation with a 4.5 mm broad LC‐DCP (4.5‐LC‐DCP) fixation to repair osteotomized equine third metacarpal (MC3) bones. Study Design— In vitro biomechanical testing of paired cadaveric equine MC3 with a mid‐diaphyseal osteotomy, stabilized by 1 of 2 methods for fracture fixation. Sample Population— Adult equine cadaveric MC3 bones (n=18 pair). Methods— MC3 were divided into 3 test groups (6 pairs each) for: (1) 4‐point bending single cycle to failure testing; (2) 4‐point bending cyclic fatigue testing; and (3) torsional single cycle to failure testing. The 8‐hole, 5.5 mm broad LC‐DCP (5.5‐LC‐DCP) was applied to the dorsal surface of 1 randomly selected bone from each pair. One 8‐hole, 4.5 mm broad LC‐DCP (4.5‐LC‐DCP) was applied dorsally to the contralateral bone from each pair. Plates and screws were applied using standard ASIF techniques. All MC3 bones had mid‐diaphyseal osteotomies. Mean test variable values for each method were compared using a paired t–test within each group. Significance was set at P<.05. Results— Mean yield load, yield bending moment, composite rigidity, failure load and failure bending moment under 4‐point bending, single cycle to failure, of the 5.5‐LC‐DCP fixation were significantly greater (P<.024) than those of the 4.5‐LC‐DCP fixation. Mean cycles to failure for 4‐point bending was significantly (P<.05) greater for the 4.5‐LC‐DCP fixation compared with the 5.5‐LC‐DCP fixation. Mean yield load, mean composite rigidity, and mean failure load in torsion for the 5.5‐LC‐DCP fixation was not significantly different (P>.05) than those with the 4.5‐LC‐DCP fixation. Conclusion— 5.5‐LC‐DCP fixation was superior to 4.5‐LC‐DCP fixation in resisting the static overload forces under palmarodorsal 4‐point bending. There was no significant difference between 5.5‐LC‐DCP fixation and 4.5‐LC‐DCP fixation in resisting static overload forces under torsion; however, the 5.5‐LC‐DCP offers significantly less stability (80% of that of the 4.5‐LC‐DCP) in cyclic fatigue testing. Clinical Relevance— The results of this in vitro study may provide information to aid in the selection of a biological plate for long bone fracture repair in horses.     

An in vitro biomechanical study of bone plate and interlocking nail in a canine diaphyseal femoral fracture model

OBJECTIVE: To compare the structural properties and the interfragmentary motion in ostectomized canine femurs stabilized with either an 8-mm interlocking nail system (IN) or a 10-hole dynamic compression broad plate (DCP). ANIMAL OR SAMPLE POPULATION: Ten pairs of adult canine femurs with a 25-mm mid-diaphyseal gap. METHODS: Bone specimens were divided into 2 groups (10 femurs each). Left femurs were stabilized with a DCP and 8 bicortical screws; right femurs were stabilized with an IN and 3 screws. Mechanical tests were performed in eccentric axial loading and in craniocaudal bending. The testing was first conducted nondestructively and then until breakage. Structural properties, ie, stiffness, yield limits, and failure limits, were determined. Interfragmentary motion was measured during nondestructive tests with the use of an optoelectronic device. Axial, transverse, and rotational motions were calculated. Mean values of stiffness, yield and failure limits, and axial and shear motions for each fixation method were compared using a paired t test within each group (P <.05). RESULTS: Mean (+/-SD) values of stiffness and failure limit were significantly higher for IN constructs than for DCP constructs in compression, while there was little difference in the results between each tested group in bending. Mean yield load values were significantly higher for IN than for DCP specimens in compression as well as in bending. The axial-motion analysis revealed significant differences between IN and DCP groups during bending tests only. The highest score of transverse motion at the gap was recorded during bending tests, and was higher for DCP than for IN specimens. There were insignificant differences between the two groups with regard to rotation around the diaphyseal axis. CONCLUSIONS AND CLINICAL RELEVANCE: Structural properties and interfragmentary shear motion analysis demonstrated a much higher rigidity in the IN-bone than in the DCP-bone constructs.     

An In Vitro Biomechanical Comparison of an Interlocking Nail System and Dynamic Compression Plate Fixation of Ostectomized Equine Third Metacarpal Bones

OBJECTIVE: To compare the mechanical properties of two stabilization methods for ostectomized equine third metacarpi (MC3): (1) an interlocking nail system and (2) two dynamic compression plates. Animal or Sample Population-Ten pairs of adult equine forelimbs intact from the midradius distally. METHODS: Ten pairs of equine MC3 were divided into two test groups (five pairs each): caudocranial four-point bending and torsion. Interlocking nails (6 hole, 13-mm diameter, 230-mm length) were placed in one randomly selected bone from each pair. Two dynamic compression plates one dorsally (12 hole, 4.5-mm broad) and one laterally (10 hole, 4.5-mm broad) were attached to the contralateral bone from each pair. All bones had 1 cm mid-diaphyseal ostectomies. Five construct pairs were tested in caudocranial four-point bending to determine stiffness and failure properties. The remaining five construct pairs were tested in torsion to determine torsional stiffness and yield load. Mean values for each fixation method were compared using a paired t-test within each group. Significance was set at P<.05. RESULTS: Mean (+/-SEM) values for the MC3-interlocking nail composite and the MC3-double plate composite, respectively, in four-point bending were: composite rigidity, 3,454+/-407.6 Nm/rad and 3,831+/-436.5 Nm/rad; yield bending moment, 276.4+/-40.17 Nm and 433.75+/-83.99 Nm; failure bending moment, 526.3+/-105.9 Nm and 636.2+/-27.77 Nm. There was no significant difference in the biomechanical values for bending between the two fixation methods. In torsion, mean (+/-SEM) values for the MC3-interlocking nail composite and the MC3-double plate composite were: composite rigidity, 124.1+/-16.61 Nm/rad and 262.4+/-30.51 Nm/rad; gap stiffness, 222.3+/-47.32 Nm/rad and 1,557+/-320.9 Nm/rad; yield load, 94.77+/-7.822 Nm and 130.66+/-20.27 Nm, respectively. Composite rigidity, gap stiffness, and yield load for double plate fixation were significantly higher compared with interlocking nail fixation in torsion. CONCLUSIONS: No significant differences in biomechanical properties were identified between an interlocking nail and double plating techniques for stabilization of ostectomized equine MC3 in caudocranial four-point bending. Double plating fixation was superior to interlocking nail fixation in torsion.     

Failure mode and bending moment of canine pancarpal arthrodesis constructs stabilized with two different implant systems

Objective— To compare failure mode and bending moment of a canine pancarpal arthrodesis construct using either a 2.7 mm/3.5 mm hybrid dynamic compression plate (HDCP) or a 3.5 mm dynamic compression plate (DCP).
Study Design— Paired in vitro biomechanical testing of canine pancarpal arthrodesis constructs stabilized with either a 2.7/3.5 HDCP or 3.5 DCP.
Sample Population— Paired cadaveric canine antebrachii (n=5).
Methods— Pancarpal arthrodesis constructs were loaded to failure (point of maximum load) in 4-point bending using a materials-testing machine. Using this point of failure, bending moments were calculated from system variables for each construct and the 2 plating systems compared using a paired t-test. To examine the relationship between metacarpal diameter and screw diameter failure loads, linear regression was used and Pearson' correlation coefficient was calculated. Significance was set at P <.05.
Results— HDCP failed at higher loads than DCP for 9 of 10 constructs. The absolute difference in failure rates between the 2 plates was 0.552±0.182 N m, P =.0144 (95% confidence interval: −0.58 to 1.68). This is an 8.1% mean difference in bending strength. There was a significant linear correlation r=0.74 ( P -slope=.014) and 0.8 ( P -slope=.006) between metacarpal diameter and failure loads for the HDCP and 3.5 DCP, respectively.
Conclusion— There was a small but significant difference between bending moment at failure between 2.7/3.5 HDCP and 3.5 DCP constructs; however, the difference may not be clinically evident in all patients.
Clinical Relevance— The 2.7/3.5 HDCP has physical and mechanical properties making it a more desirable plate for pancarpal arthrodesis.     

Comparison of limited-contact dynamic compression plate and locking compression plate constructs for proximal interphalangeal joint arthrodesis in the horse

This study compared in vitro monotonic and cyclic mechanical properties of equine proximal interphalangeal joint arthrodeses stabilized using an open or closed technique combined with axial 4.5 mm narrow limited-contact dynamic compression plate (LC-DCP) or 4.5 mm narrow locking compression plate (LCP). Ten forelimb pairs were randomly assigned to LCP or LC-DCP groups. One limb in each pair was assigned to either open or closed technique. Limbs were tested for cyclic fatigue at 20 000 cycles and then single-cycle to failure under 3-point dorsopalmar bending. There was no significant difference in stiffness of constructs during cyclic fatigue testing or on force or stiffness at failure in single cycle to failure testing between open and closed techniques or between plate types. Both implants, surgical technique, or combinations thereof are suitable for clinical use. More work is necessary to define the interaction between implant type and surgical technique.     

An In Vitro Biomechanical Comparison of Equine Proximal Interphalangeal Joint Arthrodesis Techniques: An Axial Positioned Dynamic Compression Plate and Two Abaxial Transarticular Cortical Screws Inserted in Lag Fashion Versus Three Parallel Transarticular Cortical Screws Inserted in Lag Fashion

Objectives— To compare in vitro monotonic biomechanical properties of an axial 3‐hole, 4.5 mm narrow dynamic compression plate (DCP) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion (DCP‐TLS) with 3 parallel transarticular 5.5 mm cortical screws inserted in lag fashion (3‐TLS) for the equine proximal interphalangeal (PIP) joint arthrodesis. Study Design— Paired in vitro biomechanical testing of 2 methods of stabilizing cadaveric adult equine forelimb PIP joints. Sample Population— Cadaveric adult equine forelimbs (n=15 pairs). Methods— For each forelimb pair, 1 PIP joint was stabilized with an axial 3‐hole narrow DCP (4.5 mm) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion and 1 with 3 parallel transarticular 5.5 mm cortical screws inserted in lag fashion. Five matching pairs of constructs were tested in single cycle to failure under axial compression, 5 construct pairs were tested for cyclic fatigue under axial compression, and 5 construct pairs were tested in single cycle to failure under torsional loading. Mean values for each fixation method were compared using a paired t‐test within each group with statistical significance set at P<.05. Results— Mean yield load, yield stiffness, and failure load under axial compression and torsion, single cycle to failure, of the DCP‐TLS fixation were significantly greater than those of the 3‐TLS fixation. Mean cycles to failure in axial compression of the DCP‐TLS fixation was significantly greater than that of the 3‐TLS fixation. Conclusion— The DCP‐TLS was superior to the 3‐TLS in resisting the static overload forces and in resisting cyclic fatigue. Clinical Relevance— The results of this in vitro study may provide information to aid in the selection of a treatment modality for arthrodesis of the equine PIP joint.     

Medial plating for carpal panarthrodesis

OBJECTIVE: To describe a technique for carpal panarthrodesis using a medially applied dynamic compression plate (DCP) and to evaluate outcome. STUDY DESIGN: Retrospective study. ANIMALS: Nine dogs with 10 carpal joint injuries. METHODS: Medical records of dogs that had carpal panarthrodesis by medial application of a DCP were reviewed. Signalment, cause and type of injury, preoperative treatment, operative technique, and postoperative clinical and radiographic outcome were retrieved. RESULTS: Screw loosening in the metacarpal bones required surgical revision in 3 dogs. The plate was removed because of lick dermatitis in another dog. No complications were observed in 6 arthrodeses. All dogs were subsequently sound. CONCLUSIONS: Medial application of a DCP is a reliable, reproducible method for carpal panarthrodesis. The load on the edge of the plate provides an increased area moment of inertia of the plate, enhancing it resistance to bending forces. Because of the valgus standing position of the canine carpus, dynamic compression is achieved. The DCP is secured to 1-3 metacarpal bones and loosening of the implant and bone fractures are expected to occur less frequently. CLINICAL RELEVANCE: Medial plating for carpal panarthrodesis is a valid alternative method that can be used in dogs with injuries to the carpus for which panarthrodesis of the carpal joint is indicated.     

Arthrodesis of the equine proximal interphalangeal joint: a biomechanical comparison of 3-hole 4.5 mm locking compression plate and 3-hole 4.5 mm narrow dynamic compression plate, with two transarticular 5.5 mm cortex screws

Objectives: To compare the biomechanical characteristics of 2 arthrodesis techniques for the equine proximal interphalangeal joint (PIP) using either a 3‐hole 4.5 mm locking compression plate (LCP) or 3‐hole 4.5 mm narrow dynamic compression plate (DCP), both with 2 transarticular 5.5 mm cortex screws. Study Design: Experimental. Sample Population: Cadaveric adult equine forelimbs (^*n=6 pairs). Methods: For each forelimb pair, 1 limb was randomly assigned to 1 of 2 treatment groups and the contralateral limb by default to the other treatment group. Construct stiffness, gap formation across the PIP joint, and rotation about the PIP joint were determined for each construct before cyclic axial loading and after each of four, 5000 cycle loading regimens. After the 20,000 cycle axial loading regimen, each construct was loaded to failure. Results: There were no significant differences in construct stiffness, gap formation, or sagittal plane rotation between the LCP and DCP treatment groups at any of the measured time points. Conclusion: Biomechanically, fixation of the equine PIP joint with a 3‐hole 4.5 mm LCP is equivalent to fixation with a 3‐hole 4.5 mm narrow DCP under the test conditions used.