title: Biomechanical evaluation of the less invasive stabilization system for the internal fixation of distal femur fractures.
abstract: OBJECTIVE
  Comparison between a Less Invasive Stabilization System (LISS) using monocortical screws with angular stability and two conventional plate systems Condylar Buttress Plate (CBP) and Dynamic Condylar Screw (DCS) for the treatment of distal femoral fractures with respect to biomechanical properties.
  
  
  METHODS
  Biomechanical study using paired cadaver femurs. In Test Configuration 1 (distal test), a ten-millimeter gap at the diaphysis-metaphysis junction simulates a supracondylar femoral fracture. Test Configuration 2 (proximal test) has the same configuration, but the gap was cut in the isthmic region. Proximal and distal plate ends were fixed to corresponding cortical bone fragments in both tests. Optical displacement transducers served to quantify the system's ability to withstand a stepwise increased load. Reversible (deflection) and irreversible deformation (subsidence) of the bone-plate construct was investigated.
  
  
  RESULTS
  In Test Configuration 1, LISS showed less irreversible deformation in 72 percent of the left-right comparisons. No correlation between bone mineral density, cross-section area of bones and the measured response of the construct under load was found between pairs. In Test Configuration 2, 83 percent of the left-right comparisons showed less permanent deformation but a higher elastic deformation for LISS.
  
  
  CONCLUSIONS
  These results suggest an enhanced ability to withstand high loads when using the monocortical screw fixation technique with angular stability. A higher elastic deformation of LISS compared with conventional plating systems in distal femoral fractures can be explained by the lower bending stiffness caused by different design and material properties.
authors.affiliation: Dr. H. C. Robert Mathys Stiftung, Bettlach, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Marti
authors.forename: C
authors.initials: C
authors.lastname: Fankhauser
authors.forename: A
authors.initials: A
authors.lastname: Frenk
authors.forename: J
authors.initials: J
authors.lastname: Cordey
authors.forename: B
authors.initials: B
authors.lastname: Gasser
mesh_terms: D001696:Biomechanical Phenomena; D001860:Bone Plates; D001863:Bone Screws; D002102:Cadaver; D004867:Equipment Design; D005264:Femoral Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D016268:Internal Fixators