Mono- versus polyaxial locking plates in distal femur fractures - a biomechanical comparison of the Non-Contact-Bridging- (NCB) and the PERILOC-plate

Mono- versus polyaxial locking plates in distal femur fractures - a biomechanical comparison of the Non-Contact-Bridging- (NCB) and the PERILOC-plate

The aim of this cadaveric study was to compare a polyaxial (NCB®, Zimmer) to a fixed-angle monoaxial locking plate (PERILOC®, Smith & Nephew) in comminuted fractures of the distal femur regarding stability of the construct. Up to date there is no published biomechanical data concerning polyaxial...

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Bibliographic Details
Published in:BMC musculoskeletal disorders 2014-11, Vol.15 (1), p.369-369, Article 369
Main Authors: El-Zayat, Bilal Farouk, Efe, Turgay, Ruchholtz, Steffen, Khatib, Salim, Timmesfeld, Nina, Krüger, Antonio, Zettl, Ralph
Format: Article
Language:eng
Subjects:
Aged
Aged, 80 and over
Biomechanical Phenomena
Biomechanics
Bone Plates - standards
Bones
Care and treatment
Comparative analysis
Female
Femoral Fractures - pathology
Femoral Fractures - physiopathology
Femoral Fractures - therapy
Fracture Fixation, Internal - methods
Fracture Fixation, Internal - standards
Fractures
Humans
Male
Methods
Middle Aged
Musculoskeletal diseases
Patient outcomes
Titanium alloys
Transplants & implants
Trauma
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Summary:The aim of this cadaveric study was to compare a polyaxial (NCB®, Zimmer) to a fixed-angle monoaxial locking plate (PERILOC®, Smith & Nephew) in comminuted fractures of the distal femur regarding stability of the construct. Up to date there is no published biomechanical data concerning polyaxial plating in cadaveric distal femurs. Fourteen formalin fixed femora were scanned by dual-energy x-ray absorptiometry. As fracture model an unstable supracondylar comminuted fracture was simulated. Fractures were pairwise randomly fixed either with a mono- (group A) or a polyaxial (group B) distal femur plate. The samples were tested in a servohydraulic mechanical testing system starting with an axial loading of 200 N following an increase of 200 N in every step with 500 cycles in every sequence up to a maximum of 2 000 N. The end points were implant failure or relevant loss of reduction. Data records included for each specimen time, number of cycles, axial load and axial displacement. Statistical analysis was performed using the exact Wilcoxon signed rank test. The mean donor age at the time of death was 75 years. The bone mass density (BMD) of the femurs in both groups was comparable and showed no statistically significant differences. Five bones failed before reaching the maximum applied force of 2000 N. Distribution curves of all samples in both groups, showing the plastic deformation in relation to the axial force, showed no statistically significant differences. Operative stabilization of distal femur fractures can be successfully and equally well achieved using either a monoaxial or a polyaxial locking plate. Polyaxial screw fixation may have advantages if intramedullary implants are present.
ISSN:1471-2474
1471-2474