The influence of distal screw length on the primary stability of volar plate osteosynthesis--a biomechanical study

Journal of Orthopaedic Surgery and Research
Sebastian F BaumbachYan Chevalier

Abstract

Extensor tendon irritation is one of the most common complications following volar locking plate osteosynthesis (VLPO) for distal radius fractures. It is most likely caused by distal screws protruding the dorsal cortex. Shorter distal screws could avoid this, yet the influence of distal screw length on the primary stability in VLPO is unknown. The aim of this study was to compare 75 to 100% distal screw lengths in VLPO. A biomechanical study was conducted on 11 paired fresh-frozen radii. HRpQCT scans were performed to assess bone mineral density (BMD) and bone mineral content (BMC). The specimens were randomized pair-wise into two groups: 100% (group A) and 75% (group B) unicortical distal screw lengths. A validated fracture model for extra-articular distal radius fractures (AO-23 A3) was used. Polyaxial volar locking plates were mounted, and distal screws was inserted using a drill guide block. For group A, the distal screw tips were intended to be flush or just short of the dorsal cortex. In group B, a target screw length of 75% was calculated. The specimens were tested to failure using a displacement-controlled axial compression test. Primary biomechanical stability was assessed by stiffness, elastic limit, and maximum force...Continue Reading

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Citations

Feb 14, 2016·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Alisdair R MacLeodPankaj Pankaj
Jul 19, 2018·Hand : Official Journal of the American Association for Hand Surgery·Tyler S PidgeonManuel F DaSilva
Mar 4, 2019·Current Reviews in Musculoskeletal Medicine·Daniel SeigermanPedro K Beredjiklian
Sep 2, 2020·European Radiology Experimental·Emir BencaDieter H Pahr
Feb 7, 2021·Orthopaedics & Traumatology, Surgery & Research : OTSR·Ming Fai ChengChien-Shun Wang
Jun 1, 2021·The Orthopedic Clinics of North America·Hayden S HolbrookBenjamin M Mauck

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