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J Hand Surg Am. 2006 Dec;31(10):1587-93.

Volar versus dorsal locking plates with and without radial styloid locking plates for the fixation of dorsally comminuted distal radius fractures: A biomechanical study in cadavers.

Author information

  • 1Fremantle Orthopaedic Unit, University of Western Australia, Fremantle, Western Australia, Australia.

Abstract

PURPOSE:

To compare the stability and stiffness of dorsal and volar fixed-angle distal radius constructs in a cadaveric model.

METHODS:

A locking distal radius system was used in a combination of a dorsal and styloid plate (group 1), a single volar plate (group 2), and a combination of a volar and styloid plate (group 3) configuration. In addition a single volar 3.5-mm steel locking plate was used in group 4. Each construct was tested on 6 fresh-frozen radii with simulated unstable dorsally comminuted extra-articular distal radius fractures. Specimens were tested on a material testing machine with an extensometer and subjected to axial compression fatigue and load-to-failure testing.

RESULTS:

No construct failed in fatigue testing of 250 N for 5,000 cycles. Two specimens in each group were tested for 20,000 cycles without failure. The plastic deformation in the double-plate groups was lower compared with the single-plate groups, although the difference was not statistically significant. Group 1 had the highest and group 4 the lowest failure load and stiffness, respectively. The differences between group 1 and the other groups, except failure load compared with group 3, were statistically significant. Groups 2 and 3 had a significantly higher load to failure and group 3 had a significantly higher stiffness compared with group 4.

CONCLUSIONS:

All constructs offer adequate stability with minimal deformation on fatigue testing under physiologic conditions. Dorsal fixed-angle constructs are stiffer and stronger than volar constructs. The addition of a styloid plate to a volar plate did not significantly improve stability in this model of simulated extra-articular dorsal comminution loaded in axial compression.

PMID:
17145377
[PubMed - indexed for MEDLINE]
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