A comparative mechanical analysis of plate fixation in a proximal phalangeal fracture model

The Journal of Hand Surgery
R E LinsL S Levin

Abstract

A biomechanical study compared the mechanical properties of hand and craniofacial plating systems commonly used in proximal phalangeal fractures. Two plates of each of the various systems were mounted dorsally on a yellow-birch-dowel model of a proximal phalanx after a transverse cut was made in the middle of the section of the dowel, modeling a midshaft transverse osteotomy or fracture. Torsional rigidity, as well as four-point bending rigidity in apex dorsal, lateral and volar directions, was achieved. Failure testing in apex palmar four-point bending was then examined. Between plating systems, torsion varied 1,600% and results of apex palmar testing varied 1,500%. Apex palmar moment-to-failure testing varied 1,000% and represented a 3.5%-38% range of intact proximal phalangeal strength. This also represented 12%-128% of the maximum calculated in vivo bending moments of the proximal phalanx. The wide variation in plate strengths and stiffness raises questions as to the suitability of certain plating systems with regard to early mobilization. Moreover, some plating systems tested were mechanically weaker than the reported strengths of certain Kirschner wire fixation techniques.

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Citations

Nov 19, 2005·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·K Margić
Jan 13, 2015·Archives of Orthopaedic and Trauma Surgery·Pascale Brei-ThomaTorsten Franz
Apr 10, 2003·Hand Clinics·Michael W Neumeister, Richard E Brown
Aug 22, 2007·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·George RussellHamed Benghuzzi
Oct 29, 2017·Hand : Official Journal of the American Association for Hand Surgery·Tim T LögtersRobert A Kaufmann
Sep 9, 2008·Techniques in Hand & Upper Extremity Surgery·Mark Henry
Nov 15, 2018·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Ahmet KöseTuncay Baran
Oct 4, 2008·The Journal of the American Academy of Orthopaedic Surgeons·Mark H Henry
Oct 24, 2017·International Journal of Biomaterials·Liliane Pimenta de MeloCarlos Rodrigo de Mello Roesler
Jun 14, 2021·Hand Surgery and Rehabilitation·T WuA Peng

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