Universität zu Köln

Hackl, Michael ORCID: 0000-0002-6183-5621, Wegmann, Kilian, Taibah, Soudad, Burkhart, Klaus Josef, Scaal, Martin and Mueller, Lars Peter (2015). Peri-implant failure in dual plating of the distal humerus-A biomechanical analysis with regard to screw and plate positioning. Injury-Int. J. Care Inj., 46 (11). S. 2142 - 2146. OXFORD: ELSEVIER SCI LTD. ISSN 1879-0267

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Abstract

Purpose: The aim of this biomechanical study was to analyse the influence of plate and screw positioning on peri-implant failure in dual plate osteosynthesis. We hypothesized that screw positioning rather than plate configuration influences the risk of peri-implant fractures. Methods: Twenty macerated humerus specimens were available. 5 groups of 4 were built according to specimen size. Locking dual plates (Medartis, Switzerland) were randomly applied to the distal humerus of the specimens in 4 types of configuration: P1: Parallel plate endings; positioning of the outermost screws at different levels. A1: Antiparallel plate endings; positioning of the outermost screws at different levels. A0: Antiparallel plate endings; positioning of the outermost screws at the same level. P0: Parallel plate endings; positioning of the outermost screws at the same level. Bending forces were applied using a universal testing machine until peri-implant fracture occurred. Results: Mean failure loads for respective configuration types were as follows: P1: 428.7 (+/- 84.2) N, A1: 410.0 (+/- 54.7) N, A0: 297.8 (+/- 48.3) N, P0: 261.0 (+/- 65.0) N. Configurations with positioning of the most proximal screws at different levels (P1, A1) reached significantly higher failure loads when compared to screw placement at the same level (P0, A0) (0.01 <= p <= 0.03). Altering the plate configuration did not significantly influence failure loads (0.34 <= p <= 0.58). Conclusions: The results of this study suggest that placement of the most proximal screws rather than the configuration of the plates is critical regarding the predetermined risk of peri-implant failure in dual plate osteosynthesis of the distal humerus. Varying levels of the outermost screws of corresponding double plates seem to be crucial to avoid complications related to the osteosynthesis. (C) 2015 Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hackl, Michael UNSPECIFIED orcid.org/0000-0002-6183-5621 UNSPECIFIED Wegmann, Kilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Taibah, Soudad UNSPECIFIED UNSPECIFIED UNSPECIFIED Burkhart, Klaus Josef UNSPECIFIED UNSPECIFIED UNSPECIFIED Scaal, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Lars Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-388338
DOI:	10.1016/j.injury.2015.08.015
Journal or Publication Title:	Injury-Int. J. Care Inj.
Volume:	46
Number:	11
Page Range:	S. 2142 - 2146
Date:	2015
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1879-0267
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PERIPROSTHETIC FEMORAL FRACTURES; INTERNAL-FIXATION; TIBIAL PLATEAU; OSTEOSYNTHESIS Multiple languages Critical Care Medicine; Emergency Medicine; Orthopedics; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/38833