Document Detail

Fixation of long bone segmental defects: a biomechanical study.
MedLine Citation:
PMID:  18164006     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Obtaining stable fixation in cases of long bone non-union with segmental bone defects can be challenging. Bone quality is often sub-optimal. Locking plates and structural allografts have both been used clinically in these cases. The objective of this study was to determine the biomechanical characteristics of three constructs that have been employed in this context. METHODS: A biomechanical study was performed using 3rd Generation Composite Femurs as specimens. A diaphyseal segmental defect was created and fixed with one of three constructs: (1) lateral locking plate (LP); (2) lateral non-locking plate and medial allograft strut (S); (3) lateral non-locking plate and intramedullary fibula allograft (F). The "allografts" were fashioned from 3rd generation composite bones. Axial, torsional and bending stiffness as well as load to failure were determined using a materials testing machine. RESULTS: Overall, construct S was the stiffest and construct LP was the least stiff. Construct F had intermediate characteristics. Axial load to failure for construct S (6108N) and for construct F (5344N) was significantly greater than for construct LP (2855N). CONCLUSION: When maximal stiffness is desired, a construct with a structural allograft should be chosen over a locking plate. However, biological and anatomic factors must also be taken into account when using these constructs clinically.
Max Talbot; Rad Zdero; Daniel Garneau; Peter A Cole; Emil H Schemitsch
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Publication Detail:
Type:  Journal Article     Date:  2007-12-27
Journal Detail:
Title:  Injury     Volume:  39     ISSN:  0020-1383     ISO Abbreviation:  Injury     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-06     Completed Date:  2008-08-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0226040     Medline TA:  Injury     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  181-6     Citation Subset:  IM    
1 Canadian Field Hospital, Canadian Forces, Petawawa, ON, Canada K8H 2X3.
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MeSH Terms
Analysis of Variance
Bone Plates
Bone Transplantation*
Diaphyses / physiology
Femoral Fractures / physiopathology,  surgery*
Fracture Fixation, Internal / instrumentation*,  methods
Fractures, Ununited / physiopathology,  surgery*

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