title: Biomechanical comparison of different volar fracture fixation plates for distal radius fractures.
abstract: The purpose of this study was to compare the biomechanical properties of four volar fixed-angle fracture fixation plate designs in a novel sawbones model as well as in cadavers. Four volar fixed angle plating systems (Hand Innovations DVR-A, Avanta SCS/V, Wright Medical Lo-Con VLS, and Synthes stainless volar locking) were tested on sawbones models using an osteotomy gap model to simulate a distal radius fracture. Based on a power analysis, six plates from each system were tested to failure in axial compression. To simulate loads with physiologic wrist motion, six plates of each type were then tested to failure following 10,000 cycles applying 100N of compression. To compare plate failure behavior, two plates of each type were implanted in cadaver wrists and similar testing applied. All plate constructs were loaded to failure. All failed with in apex volar angulation. The Hand Innovations DVR-A plate demonstrated significantly more strength in peak load to failure and failure after fatigue cycling (p value < 0.001 for single load and fatigue failure). However, there was no significant difference in stiffness among the four plates in synthetic bone. The cadaveric model demonstrated the same mode of failure as the sawbones. None of the volar plates demonstrated screw breakage or pullout, except the tine plate (Avanta SCS/V) with 1 mm of pullout in 2 of 12 plates. This study demonstrates the utility of sawbones in biomechanical testing and indicates that volar fixation of unstable distal radius fractures with a fixed angle device is a reliable means of stabilization.
authors.affiliation: Department of Orthopaedics, University of Colorado Health Sciences Center, 4200 E. 9th Avenue, B202, Denver, CO, 80262, USA.
authors.forename: Kareem
authors.initials: K
authors.lastname: Sobky
authors.forename: Todd
authors.initials: T
authors.lastname: Baldini
authors.forename: Kenneth
authors.initials: K
authors.lastname: Thomas
authors.forename: Joel
authors.initials: J
authors.lastname: Bach
authors.forename: Allison
authors.initials: A
authors.lastname: Williams
authors.forename: Jennifer Moriatis
authors.initials: JM
authors.lastname: Wolf
references.citation: J Hand Surg Am. 2003 Jan;28(1):94-104
references.pmid: 12563644
references.citation: J Hand Surg Br. 2003 Jun;28(3):263-6
references.pmid: 12809662
references.citation: J Hand Surg Am. 2002 Mar;27(2):205-15
references.pmid: 11901379
references.citation: Clin Biomech (Bristol, Avon). 2007 Jun;22(5):510-7
references.pmid: 17328995
references.citation: J Hand Surg Am. 2006 May-Jun;31(5):771-9
references.pmid: 16713841
references.citation: J Bone Joint Surg Am. 2002 Aug;84(8):1315-22
references.pmid: 12177259
references.citation: Clin Orthop Relat Res. 2006 Apr;445:58-67
references.pmid: 16505728
references.citation: J Orthop Trauma. 2005 Mar;19(3):187-91
references.pmid: 15758672
references.citation: J Hand Surg Am. 2004 May;29(3):446-51
references.pmid: 15140488
references.citation: J Orthop Trauma. 2006 Feb;20(2):115-21
references.pmid: 16462564
references.citation: J Bone Joint Surg Am. 1997 Sep;79(9):1303-12
references.pmid: 9314392
references.citation: J Hand Surg Br. 2000 Dec;25(6):528-34
references.pmid: 11106513
references.citation: J Hand Surg Am. 2006 Mar;31(3):359-65
references.pmid: 16516728
references.citation: J Hand Surg Am. 2006 Mar;31(3):382-6
references.pmid: 16516731
references.citation: J Hand Surg Am. 2006 Sep;31(7):1061-7
references.pmid: 16945704
references.citation: J Hand Surg Am. 1997 Sep;22(5):777-84
references.pmid: 9330133
references.citation: J Hand Surg Am. 2006 Dec;31(10):1587-93
references.pmid: 17145377
references.citation: J Bone Joint Surg Am. 1986 Jun;68(5):647-59
references.pmid: 3722221
references.citation: J Bone Joint Surg Am. 2003 Oct;85(10):1956-60
references.pmid: 14563804
references.citation: J Bone Joint Surg Am. 2006 Nov;88(11):2411-7
references.pmid: 17079398
references.citation: Ann Plast Surg. 2000 May;44(5):564-6
references.pmid: 10805309
references.citation: Chir Main. 2001 Jun;20(3):218-25
references.pmid: 11496608
references.citation: Instr Course Lect. 1999;48:465-80
references.pmid: 10098077
references.citation: J Trauma. 2006 Sep;61(3):668-72
references.pmid: 16967005
references.citation: J Hand Surg Am. 2002 Jul;27(4):724-8
references.pmid: 12132102
references.citation: J Hand Surg Am. 1990 May;15(3):393-400
references.pmid: 2348055
references.citation: J Hand Surg Am. 2007 Feb;32(2):194-9
references.pmid: 17275594
references.citation: J Hand Surg Am. 1998 Jan;23(1):127-34
references.pmid: 9523966