Biomechanical Comparison of Fixation Techniques in Midshaft Clavicular Fractures
JOURNAL OF ORTHOPAEDIC TRAUMA, vol.25, no.5, pp.272-278, 2011 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 25 Issue: 5
- Publication Date: 2011
- Doi Number: 10.1097/bot.0b013e3181ee3db7
- Journal Name: JOURNAL OF ORTHOPAEDIC TRAUMA
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Page Numbers: pp.272-278
- Keywords: clavicular fracture, biomechanical testing, osteosynthesis implants, torsion, bending, cyclic loading, MECHANICAL-PROPERTIES, EXTERNAL FIXATION, PLATE, NONUNION
- Acibadem Mehmet Ali Aydinlar University Affiliated: No
Abstract
Objectives: The purpose of this study is to evaluate the biomechanical properties and the stability among a locking clavicle plate (LCP), a dynamic compression plate (DCP) and an external fixator (Ex-fix) in an unstable displaced clavicle fracture model under torsional and three-point bending loading. Materials and Methods: Forty-eight human adult formalin-fixed clavicles were paired according to their bone mineral density homogeneously into three groups: LCP, DCP, and Ex-fix. Each specimen was osteotomized at the midshaft. Torsional and three-point bending forces were performed for 1000 cycles with stiffness recorded at 10 cycles (initial) and then at 100-cycle intervals thereafter. Initial stiffness, failure loads, and the percentage of initial stiffness at the various intervals were compared using analysis of variance. Results: The mean initial stiffness values (Nmm/deg) for torsion were 703.2 (LCP), 448.1 (DCP), and 365.2 (Ex-fix). The mean failure moments (Nmm) for torsion were 7671.7 (LCP), 4370.3 (DCP), and 2999.7 (Ex-fix). The mean initial stiffness (Nmm) for bending were 32.6 (LCP), 23.4 (DCP), and 20.6 (Ex-fix). The mean failure loads (N) for bending were 213.2 (LCP), 131.1 (DCP), and 102.7 (Ex-fix). For both torsion and bending, an overall significant difference among the three constructs in terms of failure loads and also a significant difference between the locking plate and the other two models only in terms of initial stiffness was seen. For torsion and bending, at all cyclic intervals, there was a significant difference between the locking plate and the other two models. After 700 cycles, a significant difference was also detected between the DCP and Ex-fix in torsion, but no difference was found between these groups at any cyclic interval in bending. Conclusions: The locking plate is significantly more stable than DCP and Ex-fix under torsional and bending cyclic loading in a displaced fracture clavicle model.