%0 Journal Article
%T Comparing the In Vitro Stiffness of Straight-DCP, Wave-DCP, and LCP Bone Plates for Femoral Osteosynthesis
%A Jos¨¦ Ricardo Lenzi Mariolani
%A William Dias Belangero
%J ISRN Orthopedics
%D 2013
%R 10.1155/2013/308753
%X The objective of this study was to compare the Locking Compression Plate (LCP) with the more cost-effective straight-dynamic compression plate (DCP) and wave-DCPs by testing in vitro the effects of plate stiffness on different types of diaphyseal femur fractures (A, B, and C, according to AO classification). The bending structural stiffness of each plate was obtained from four-point bending tests according to ASTM F382-99(2008). The plate systems were tested by applying compression/bending in different osteosynthesis simulation models using wooden rods to simulate the fractured bone fragments. Kruskal-Wallis test showed no significant difference in the bending structural stiffness between the three plate models. Rank-transformed two-way ANOVA showed significant influence of plate type, fracture type, and interaction plate versus fracture on the stiffness of the montages. The straight-DCP produced the most stable model for types B and C fractures, which makes its use advantageous for complex nonosteoporotic fractures that require minimizing focal mobility, whereas no difference was found for type A fracture. Our results indicated that DCPs, in straight or wave form, can provide adequate biomechanical properties for fixing diaphyseal femoral fractures in cases where more modern osteosynthesis systems are cost restrictive. 1. Introduction The current standard of care for femoral fractures is the intramedullary nail, but there are situations in which the use of plates is indicated, like narrow medullary cavity, bone deformities, and open growth plate. Metal plates have been used for the fixation of fractures since the end of the 19th century. The DCP, designed with oblong holes to provide interfragmentary compression when tightening the screws, was introduced in 1969 [1]. At that time, researchers believed that ˇ°absoluteˇ± stability was the best method for treating long bone diaphyseal fractures, but a high rate of nonunions and postoperative infections questioned this concept only a few decades later [2¨C4]. As opposed to the wide surgical approach required by this technique, it has been suggested that less manipulation of the bone fragments would result in faster bone healing by preserving the fracture site vasculature [5]. Consequently, osteosynthesis techniques were modified [2, 4, 6¨C8] to minimize damage to the soft tissue and periosteum in order to preserve the fracture vascularization [2, 7]. The authoritative work of Heitemeyer et al. [9] demonstrated that this new protocol improved complex fracture healing of the femur diaphysis. Appropriate stress
%U http://www.hindawi.com/journals/isrn.orthopedics/2013/308753/