Skip to main content

Mechanical evaluation of fourth-generation composite femur hybrid locking plate constructs

Journal of Materials Science: Materials in Medicine volume 22, Article number: 2139 (2011) Cite this article

Abstract

Locking compression plates are routinely used for open reduction and internal fixation of fractures. Such plates allow for locking or non-locking screw placement in each hole. A combined use of both types of screw application for stabilization of a fracture is commonly applied and referred to as hybrid internal fixation. Locking screws improve the stability of the fixation construct but at the expense of significant additional cost. This study experimentally analyzes various combinations of locking and non-locking screws under simultaneous axial and torsional loading to determine the optimal hybrid locking plate—screw construct in a fourth generation composite femur. Clinically it is necessary to ensure adequate fixation stability in a worse case fracture-bone quality scenario. A locking screw near the fracture gap increased the axial and torsional strength of the locked plate system. Greater removal torque remained in non-locked screws adjacent to locked screws compared to an all non-locking screws control group.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

References

  1. Iqbal M. Osteoporosis: epidemiology, diagnosis, and treatment. South Med J. 2000;9:2–18.

    Google Scholar 

  2. Miranda M. Locking plate technology and its role in osteoporotic fractures. Inj, Int J Care Inj. 2007;38S3:S35–9.

    Google Scholar 

  3. Luo C. Locking compression plating: a new solution for fractures in rheumatoid patients. Mod Rheumatol. 2005;15:169–72.

    Article  Google Scholar 

  4. Miller D, Goswami T. A review of locking compression plate biomechanics and their advantages as internal fixators in fracture healing. Clin Biomech. 2007;22:1049–62.

    Article  Google Scholar 

  5. Haidukewych G. Innovations in locking plate technology. J Am Acad Orthop Surg. 2004;12(4):205–12.

    Google Scholar 

  6. Aguila AZ, Manos JM, Orlansky AS, Todhunter RJ, Trotter EJ, Van der Meulen MC. In vitro biomechanical comparison of limited contact dynamic compression plate and locking compression plate. Vet Comp Orthop Traumatol. 2005;18(4):220–6.

    CAS  Google Scholar 

  7. Ahmad M, Nanda AS, Bajwa AS, Candal-Couto J, Green S, Hui AC. Biomechanical testing of the locking compression plate: when does the distance between bone and implant significantly reduce construct stability? Injury. 2007;38:358–64.

    Article  CAS  Google Scholar 

  8. Kim TUM, Ayturk A, Aiclau TH, Puttlitz CM. Fixation of osteoporotic distal fibula fractures: a biomechanical comparison of locking versus conventional plates. J Foot Ankle Surg. 2007;46(1):2–6.

    Article  Google Scholar 

  9. Uhthoff H, Poitras P, Backman D. Internal plate fixation of fractures: short history and recent developments. J Orthop Sci. 2006;11:118–26.

    Article  Google Scholar 

  10. Perren SM, Russenberger M, Steinmann S, Muller ME, Allgower M. A dynamic compression plate. Acta Orthopaedica Scandinavica. 1969;125(suppl):31–41.

    CAS  Google Scholar 

  11. Tepic S, Perren SM. The biomechanics of the PC-Fix internal fixator. Elsevier. 1995;26(Suppl 2):5–10.

    Google Scholar 

  12. Sommer C. Biomechanics and clinical application principles of locking plates. Suomen Ortopedia Ja Traumatologia. 2006;29:20–4.

    Google Scholar 

  13. Wagner, M (2003) General principles for the clinical use of the LCP. Injury 34, SB31–SB42.

    Google Scholar 

  14. Schandelmaier P, Stephan C, Reimers N, Krettek C. LISS osteosynthesis for distal fractures of the femur. Trauma Berufskrankh. 1999;1:392–7.

    Article  Google Scholar 

  15. Frigg R (2003) Development of the locking compression plate. Injury 34: SB6–SB10.

    Google Scholar 

  16. Frigg R. Locking compression plate (LCP). An osteosynthesis plate based on the dynamic compression plate and the point contact fixator (PC-Fix). Injury. 2001;32:63–6.

    Article  Google Scholar 

  17. Frigg R. Development of the locking compression plate. Injury. 2003;34:6–10.

    Article  Google Scholar 

  18. Hou Sheng-Mou, Ching CH, Jaw LW, Chao CK, Jinn L. Mechanical tests and finite element models for bone holding power of tibial locking screws. Clin Biomech. 2004;19:738–45.

    Article  Google Scholar 

  19. Perren SM, Klaue K, Pohler O, Predieri M, Steinemann S, Gautier E. The limited contact dynamic compression plate (LC-DCP). Arch Orthop Trauma Surg. 1990;109:304–10.

    Article  CAS  Google Scholar 

  20. Niemeyer P, Sudkamp NP. Principles and clinical application of the locking compression plate (LCP). Acta Chir Orthop Traumatol cCech. 2006;73(4):221–8.

    CAS  Google Scholar 

  21. Gardner MP, Chong ACM, Pollock AG, Wooley PH. Mechanical evaluation of large-size fourth generation composite femur and tibia models. Ann Biomed Eng. 2010;3(38):613–20.

    Article  Google Scholar 

  22. Faruok O, Krettek C, Miclau T, Schandelmaier P, Guy P, Tscherne H. Minimally invasive plate osteosynthesis and vascularity: preliminary results of a cadaver infection study. Injury. 1997;28:SA7–12.

    Google Scholar 

  23. 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(8):571–7.

    Article  CAS  Google Scholar 

  24. Stoffel K, Dieter U, Stachowiak G, Gachter A, Kuster M. Biomechanical testing of the LCP: how can stability in locked internal fixators be controlled? Injury. 2003;34:11–9.

    Article  Google Scholar 

  25. Gautier E, Sommer C. Guidelines for the clinical application of the LCP. Injury. 2003;34:63–76.

    Article  Google Scholar 

  26. Edwards T, Eelen G, English H, Crawford R. Stripping torque as a predictor of successful internal facture fixation. Surgery. 2005;75:1096–9.

    Google Scholar 

  27. Gardner MJ, Griffith MH, Demetrakopoulos D, Brophy RH, Grose A, Helfet DL, Lorich DG. Hybrid locked plating of osteoporotic fractures of the humerus. J Bone Joint Surg. 2006;88A(9):1962–7.

    Article  Google Scholar 

  28. Gaines D, Ervin T, Rudd J, Goullett R, Keyser R, Currey T, Nowotarski PJ, Norris BL. Plate length, screw position, and locking screw effects on bridge plating for femur fractures. In: 23rd Annual Mtg, of the Mid-America Orthopaedic Association, Amelia Island; 2005.

  29. Sikes J, Smith B, Mukhertee D, Coward K. Comparison of fixation strengths of locking head and conventional screws in fracture and reconstruction models. J Oral Maxillofacial Surg. 1998;56:468–73.

    Article  Google Scholar 

  30. Jewell DP, Gheduzzi AS, Mitchell MS, Miles AW. Locking plates increase the strength of dynamic hip screws. Injury, Int J Care Inj. 2008;39:209–12.

    Google Scholar 

Download references

Acknowledgments

The authors of this study would like to thank Dishita Patel for editing and formatting the study.

Author information

Affiliations

  1. Department of Biomedical, Industrial and Human Factor Engineering, Wright State University, Dayton, USA

    Tarun Goswami & Vinit Patel

  2. Department of Orthopedic Surgery, Wright State University, Dayton, USA

    Tarun Goswami, David J. Dalstrom & Michael J. Prayson

Authors
  1. Tarun Goswami
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vinit Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David J. Dalstrom
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael J. Prayson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tarun Goswami.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Goswami, T., Patel, V., Dalstrom, D.J. et al. Mechanical evaluation of fourth-generation composite femur hybrid locking plate constructs. J Mater Sci: Mater Med 22, 2139 (2011). https://doi.org/10.1007/s10856-011-4388-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10856-011-4388-2

Keywords

  • Torque
  • Torsional Stiffness
  • Osteoporotic Bone
  • Axial Stiffness
  • Torsional Loading