Biomechanical comparison of the Locking Compression superior anterior clavicle plate with seven and ten hole reconstruction plates in midshaft clavicle fracture stabilisation.
OBJECTIVE
The purpose of this study was to characterise the biomechanical properties of the seven hole superior anterior clavicle LCP (locking compression plate) and to compare these with the properties of commonly applied implants used for the stabilisation of clavicular midshaft fractures such as the locking 7- and ten hole reconstruction plate.


METHODS
Twenty-four synthetic clavicles were used. A transverse midshaft fracture was induced. The clavicles were fixed with angle stable clavicle LCPs, seven hole and ten hole reconstruction plates (n = 8 each). Twenty cycles of axial compression and torsion were performed for each sample, which was followed by 1,000 cycles of three point bending and ultimately bending to failure. Axial, torsional and cantilever bending stiffness were calculated from the data recorded.


RESULTS
The clavicle LCP showed the highest overall stiffness compared to the seven and ten hole reconstruction plate. Significantly higher stiffness values were found for axial compression and external rotation. In the load-to-failure tests, the ten hole reconstruction plate especially showed early signs of plastic deformation, which might account for early plate insufficiency so frequently observed clinically.


CONCLUSIONS
The results indicate that the clavicle LCP, as compared to the reconstruction plates, leads to superior biomechanical stability in the treatment of midshaft clavicle fractures.
Department of Trauma-, Hand-, Plastic and Reconstructive Surgery, Julius-Maximilians-University, Würzburg, Germany. eden.lars@web.de
Lars
L
Eden
Stefanie
S
Doht
Sönke P
SP
Frey
Dirk
D
Ziegler
Jan
J
Stoyhe
Kai
K
Fehske
Torsten
T
Blunk
Rainer H
RH
Meffert
D001696:Biomechanical Phenomena; D001860:Bone Plates / Q000592:standards*; D002102:Cadaver; D002968:Clavicle / Q000293:injuries* / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008422:Materials Testing / Q000379:methods; D019637:Orthopedic Procedures / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome