Biomechanical Comparison of Volar Fixed-Angle Locking Plates for AO C3 Distal Radius Fractures: Titanium Versus Stainless Steel With Compression.

Abstract

PURPOSE:

To determine biomechanical differences between a fixed-angle locking volar titanium plate (VariAx; Stryker, Kalamazoo, MI) and a fixed-angle compression locking volar stainless steel plate (CoverLoc Volar Plate; Tornier, Amsterdam, Netherlands) in the fixation of simulated AO C3 distal radius fractures.

METHODS:

Eighteen cadaveric upper extremities (9 matched pairs) with an average age of 54 years were tested. A 4-part AO C3 fracture pattern was created in each specimen. The fractures were reduced under direct vision and fixed with either the fixed-angle locking volar titanium plate or the fixed-angle compression locking volar stainless steel plate. Motion tracking analysis was then performed while the specimens underwent cyclic loading. Changes in displacement, rotation, load to failure, and mode of failure were recorded.

RESULTS:

The fragments, when secured with the fixed-angle compression locking stainless steel construct, demonstrated less displacement and rotation than the fragments secured with the fixed-angle locking titanium plate under physiological loading conditions. In the fixed-angle compression locking stainless steel group, aggregate displacement and rotation of fracture fragments were 5 mm and 3° less, respectively, than those for the fixed-angle locking titanium group. The differences between axial loads at mechanical failure and stiffness were not statistically significant. The compression locking stainless steel group showed no trend in mode of failure, and the locking titanium plate group failed most often by articular fixation failure (5 of 9 specimens).

CONCLUSIONS:

The fixed-angle compression locking stainless steel volar plate may result in less displacement and rotation of fracture fragments in the fixation of AO C3 distal radius fractures than fixation by the fixed-angle locking volar titanium plate. However, there were no differences between the plates in mechanical load to failure and stiffness.

CLINICAL RELEVANCE:

Fixation of distal radius AO C3 fracture patterns with the fixed-angle compression locking stainless steel plate may provide improved stability of fracture fragments.

• Authors: Tyler Marshall, Amit Momaya, Alan Eberhardt, Nilesh Chaudhari, Thomas R Hunt 3rd
• Journal: The Journal of hand surgery (J Hand Surg Am) Vol. 40 Issue 10 Pg. 2032-8 (Oct 2015) ISSN: 1531-6564 [Electronic] United States
• PMID: 26253601 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Chemical References

• Stainless Steel
• Titanium

Topics

• Adult
• Aged
• Biomechanical Phenomena
• Bone Plates
• Cadaver
• Compressive Strength
• Equipment Design
• Female
• Fracture Fixation, Internal (instrumentation, methods)
• Humans
• Male
• Middle Aged
• Netherlands
• Palmar Plate (surgery)
• Radiography
• Radius Fractures (diagnostic imaging, surgery)
• Sensitivity and Specificity
• Stainless Steel
• Titanium
• Wrist Injuries (diagnostic imaging, surgery)