A biomechanical evaluation of locked plating for distal fibula fractures in an osteoporotic sawbone model.
BACKGROUND
Supination external rotation (SER) injuries are commonly fixed with a one third tubular neutralization plate. This study investigated if a combination locked plate with additional fixation options was biomechanically superior in osteoporotic bone and comminuted fracture models.


METHODS
Using an osteoporotic and a comminuted Sawbones model, SER injuries were fixed with a lag screw for simple oblique fibula fractures, and either a one third tubular neutralization plate or a locking plate. Samples were tested in stiffness, peak torque, displacement at failure, and torsion fatigue.


RESULTS
There was no statistically significant difference in biomechanical testing for fractures treated with a lag screw and plate. For comminuted fractures, locked plating demonstrated statistically significant stiffer fixation.


CONCLUSIONS
A combination locked plate is biomechanically superior to a standard one third tubular plate in comminuted SER ankle fractures. There was no biomechanical superiority between locked and one third tubular plates when the fracture was amenable to a lag screw.
Department of Orthopedics, Warren Alpert Medical School, Brown University, 2 Dudley Street, Providence, RI 02903, United States.
Jason T
JT
Bariteau
Department of Orthopedics, Warren Alpert Medical School, Brown University, 2 Dudley Street, Providence, RI 02903, United States. Electronic address: amanda.fantry@gmail.com.
Amanda
A
Fantry
Department of Orthopedics, Warren Alpert Medical School, Brown University, 2 Dudley Street, Providence, RI 02903, United States.
Brad
B
Blankenhorn
Department of Orthopedics, Warren Alpert Medical School, Brown University, 2 Dudley Street, Providence, RI 02903, United States.
Craig
C
Lareau
Department of Orthopedics, Warren Alpert Medical School, Brown University, 2 Dudley Street, Providence, RI 02903, United States.
David
D
Paller
Department of Orthopedics, Warren Alpert Medical School, Brown University, 2 Dudley Street, Providence, RI 02903, United States.
Christopher W
CW
Digiovanni
D001696:Biomechanical Phenomena; D001860:Bone Plates; D005360:Fibula / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation; D050723:Fractures, Bone / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008962:Models, Theoretical; D010024:Osteoporosis / Q000150:complications*
Ankle fracture; Osteoporotic; Sawbones model; Supination external rotation