Skip to main content
Log in

Stability of volar locking plate systems for AO type C3 fractures of the distal radius: biomechanical study in a cadaveric model

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

The purpose of the present study was to compare the relative stability of five volar locking plates (all of which are available for the treatment of intraarticular fractures of the distal radius) under loading conditions simulating the physiological forces that occur during early active mobilization.

Methods

Five plating techniques were applied to surgically simulated AO type C3.2 distal radius fractures in formalin-fixed cadavers. The specimens were tested with a servohydraulic materials testing machine with 250 N of axial compression load for 3000 cycles. After cyclic loading, the specimens were loaded until they demonstrated failure in axial compression. The five fixation systems studied included a DRV locking plate (group 1), a Stellar plate (group 2), an Acu-Loc plate (group 3), AO Locking Distal Radius System 2.4 (group 4); and a Matrix SmartLock plate (group 5).

Results

None of the plate fixations tested failed during the cyclic loading. Group 2 had a higher elastic limit than groups 4 and 5. There were no significant differences among the five groups for the failure load. Failure occurred at the distal portion of the fixation system, at the ulnar side locking pin, or the locking screw was bent (groups 1, 2, 3); the ulnar side locking screw was broken (groups 3, 4); the locking screw became loose (group 4); and the ulnar side locking screw was uncoupled from the screw hole (group 5).

Conclusions

All of the five volar plate fixation systems provided sufficient stability to permit 3000 repeated motions of the digits after surgery for AO type C3 distal radius fractures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Orbay JL. The treatment of unstable distal radius fractures with volar fixation. Hand Surg 2000;5:103–112.

    Article  CAS  PubMed  Google Scholar 

  2. Kamano M, Honda Y, Kazuki K, Yasuda M. Palmar plating for dorsally displaced fractures of the distal radius. Clin Orthop 2002;397:403–408.

    Article  PubMed  Google Scholar 

  3. Drobetz H, Kutscha-Lissberg E. Osteosynthesis of distal radial fractures with a volar locking screw plate system. Int Orthop 2003;27:1–6.

    CAS  PubMed  Google Scholar 

  4. Musgrave DS, Idler RS. Volar fixation of dorsally displaced distal radius fractures using the 2.4-mm locking compression plates. J Hand Surg [Am] 2005;30:743–749.

    Article  Google Scholar 

  5. Wright TW, Horodyski M, Smith DW. Functional outcome of unstable distal radius fractures: ORIF with a volar fixed-angle tine plate versus external fixation. J Hand Surg [Am] 2005;30:289–299.

    Article  Google Scholar 

  6. Osada D, Fujita S, Tamai K, Iwamoto A, Tomizawa K, Saotome K. Biomechanics in uniaxial compression of three distal radius volar plates. J Hand Surg [Am] 2004;29:446–451.

    Article  Google Scholar 

  7. Osada D, Viegus SF, Shar MA, Morris RP, Patterson RM. Comparison of different distal radius dorsal and volar fracture fixation plates: a biomechanical study. J Hand Surg [Am] 2003;28:94–104.

    Article  Google Scholar 

  8. Liporace FA, Gupta S, Jeong GK, Stracher M, Kummer F, Egol KA, et al. A biomechanical comparison of a dorsal 3.5-mm T-plate and a volar fixed-angle plate in a model of dorsally unstable distal radius fractures. J Orthop Trauma 2005;19:187–191.

    Article  PubMed  Google Scholar 

  9. Trease C, McIff T, Toby EB. Locking versus nonlocking T-plates for dorsal and volar fixation of dorsally comminuted distal radius fractures: a biomechanical study. J Hand Surg [Am] 2005;30:756–763.

    Article  Google Scholar 

  10. Koh S, Morris RP, Patterson RM, Kearney JP, Buford WL, Viegas SF. Volar fixation for dorsally angulated extra-articular fractures of the distal radius: a biomechanical study. J Hand Surg [Am] 2006;31:771–779.

    Article  Google Scholar 

  11. Müller LP, Klitscher D, Rudig L, Mehler D, Rommens PM, Prommersberger KJ. Locking plates for corrective osteotomy of malunited dorsally tilted distal radial fractures: a biomechanical study. J Hand Surg [Br] 2006;31:556–561.

    Google Scholar 

  12. Leung F, Zhu L, Ho H, Lu WW, Chow SP. Palmar plate fixation of AO type C2 fracture of distal radius using a locking compression plate: a biomechanical study in a cadaveric model. J Hand Surg [Br] 2003;28:263–266.

    CAS  Google Scholar 

  13. Taylor KF, Parks BG, Segalman KA. Biomechanical stability of a fixed-angle volar plate versus fragment-specific fixation system: cycle testing in a C2-type distal radius cadaver fracture model. J Hand Surg [Am] 2006;31:373–381.

    Article  Google Scholar 

  14. Grindel SI, Wang M, Gerlach M, McGrady LM, Brown S. 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;32:194–199.

    Article  Google Scholar 

  15. Martineau PA, Waitayawinyu T, Malone KJ, Hanel DP, Trumble TE. Volar plating of AO C3 distal radius fractures: biomechanical evaluation of locking screw and locking smooth peg configurations. J Hand Surg [Am] 2008;33:827–834.

    Article  CAS  Google Scholar 

  16. Gesensway D, Putnam MD, Mente PL, Lewis JL. Design and biomechanics of a plate for the distal radius. J Hand Surg [Am] 1995;20:1021–1027.

    Article  CAS  Google Scholar 

  17. Yetkinler DN, Ladd AL, Poster RD, Constantz BR, Carter D. Biomechanical evaluation of fixation of intra-articular fractures of the distal part of the radius in cadavera: Kirschner wires compared with calcium-phosphate bone cement. J Bone Joint Surg [Am] 1999;81:391–399.

    CAS  Google Scholar 

  18. Viegas SF, Tencer AF, Cantrell J, Chang M, Clegg P, Hicks C, et al. Load transfer characteristics of the wrist. Part 1. The normal joint. J Hand Surg [Am] 1987;12:971–978.

    CAS  Google Scholar 

  19. Sommer C, Babst R, Muller M, Hanson B. Locking compression plate loosening and plate breakage: a report of four cases. J Orthop Trauma. 2004;18:571–577.

    Article  CAS  PubMed  Google Scholar 

  20. Saeki Y, Hashizume H, Nagoshi M, Tanaka H, Inoue H. Mechanical strength of intramedullary pinning and transfragmental Kirschner wire fixation for Colles’ fractures. J Hand Surg [Br] 2001;26:550–555.

    CAS  Google Scholar 

  21. Dodds SD, Cornelissen S, Jossan S, Wolfe SW. A biomechanical comparison of fragment-specific fixation and augmented external fixation for intra-articular distal radius fractures. J Hand Surg [Am] 2002;27:953–964.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

About this article

Cite this article

Kamei, S., Osada, D., Tamai, K. et al. Stability of volar locking plate systems for AO type C3 fractures of the distal radius: biomechanical study in a cadaveric model. J Orthop Sci 15, 357–364 (2010). https://doi.org/10.1007/s00776-010-1466-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00776-010-1466-0

Keywords

Navigation