title: The dynamic locking screw (DLS) can increase interfragmentary motion on the near cortex of locked plating constructs by reducing the axial stiffness.
abstract: BACKGROUND
  The plate-screw interface of an angular stable plate osteosynthesis is very rigid. So far, all attempts to decrease the stiffness of locked plating construct, e.g. the bridged plate technique, decrease primarily the bending stiffness. Thus, the interfragmentary motion increases only on the far cortical side by bending the plate. To solve this problem, the dynamic locking screw (DLS) was developed.
  
  
  METHODS
  Comparison tests were performed with locking screws (LS) and DLS. Axial stiffness, bending stiffness and interfragmentary motion were compared. For measurements, we used a simplified transverse fracture model, consisting of POM C and an 11-hole LCP3.5 with a fracture gap of 3 mm. Three-dimensional fracture motion was detected using an optical measurement device (PONTOS 5 M/GOM) consisting of two CCD cameras (2,448 x 2,048 pixel) observing passive markers.
  
  
  RESULTS
  The DLS reduced the axial stiffness by approximately 16% while increasing the interfragmentary motion at the near cortical side significantly from 282 microm (LS) to 423 microm (DLS) applying an axial load of 150 N.
  
  
  CONCLUSIONS
  The use of DLS reduces the stiffness of the plate-screw interface and thus increases the interfragmentary motion at the near cortical side without altering the advantages of angular stability and the strength.
authors.affiliation: Klinik für Orthopädie und Unfallchirurgie, Abteilung für Unfallchirurgie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Germany. doebele@tum.de
authors.forename: Stefan
authors.initials: S
authors.lastname: Döbele
authors.forename: Carsten
authors.initials: C
authors.lastname: Horn
authors.forename: Stefan
authors.initials: S
authors.lastname: Eichhorn
authors.forename: Arne
authors.initials: A
authors.lastname: Buchholtz
authors.forename: Andreas
authors.initials: A
authors.lastname: Lenich
authors.forename: Rainer
authors.initials: R
authors.lastname: Burgkart
authors.forename: Andreas K
authors.initials: AK
authors.lastname: Nüssler
authors.forename: Martin
authors.initials: M
authors.lastname: Lucke
authors.forename: Daniel
authors.initials: D
authors.lastname: Andermatt
authors.forename: Rudolf
authors.initials: R
authors.lastname: Koch
authors.forename: Ulrich
authors.initials: U
authors.lastname: Stöckle
mesh_terms: D001696:Biomechanical Phenomena; D001860:Bone Plates; D001863:Bone Screws; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008954:Models, Biological; D013978:Tibial Fractures / Q000601:surgery*