Distal femoral fixation: a biomechanical comparison of the standard condylar buttress plate, a locked buttress plate, and the 95-degree blade plate.
OBJECTIVE
This biomechanical cadaver study was performed to compare the fixation stability of a standard lateral condylar buttress plate with a similar condylar buttress plate with the distal screws locked to the plate. Then the study was repeated with six additional matched femoral pairs to compare the locked plate with a standard 95-degree blade plate.


METHODS
Six matched pairs of mildly osteopenic femurs were selected, and each side was assigned randomly to fixation with either a standard lateral condylar buttress plate or a modified lateral condylar buttress plate with locked distal screws. The experiment was repeated with six additional matched pairs of femurs instrumented with either a modified lateral condylar buttress plate with locked distal screws or a standard 95-degree blade plate.


METHODS
The femurs were instrumented, and a gap osteotomy was created at the distal femoral metaphysis. The instrumented femurs were then mechanically tested in axial compression and bending/torsional loading to determine fixation stability; then they were loaded at 1,000 newtons for 10(5) cycles and retested for stability.


METHODS
The displacement across the osteotomy gap at 100-newton and 1,000-newton axial loads was measured directly for each specimen before and after cycling. In addition, resistance to displacement in bending/torsional loading (newtons/centimeter) was determined from load/displacement curves, before and after cycling.


RESULTS
The locked buttress plate provided significantly greater fixation stability than the standard plate both before and after cycling in axial loading. The locked buttress plate also proved significantly more stable in axial loading than the blade plate both before and after cycling.


CONCLUSIONS
A condylar buttress plate with locked screws is a valid concept for improving fixation stability.
Koval
K J
KJ
Department of Orthopaedic Surgery, Hospital for Joint Diseases, New York, New York 10003, USA.
Hoehl
J J
JJ
Kummer
F J
FJ
Simon
J A
JA
D001696:Biomechanical Phenomena; D001860:Bone Plates; D002102:Cadaver; D004867:Equipment Design; D005264:Femoral Fractures / Q000601:surgery*; D005592:Fracture Fixation / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D066298:In Vitro Techniques; D007593:Joint Instability; D008953:Models, Anatomic; D011897:Random Allocation; D012016:Reference Values; D016474:Weight-Bearing