Angular stable plate fixation provides favorable biomechanical stability in simulated T-shaped acetabular fractures: a biomechanical study

Background and purpose: The treatment of acetabular fractures remains technically demanding. In the case of reduced bone quality or fracture morphology reducing the amount of bone available for fixation, locking plates should provide considerable advantages. The aim of the present study was to comp...

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Main Authors: Moritz F Lodde, Christoph Katthagen, Matthias Klimek, Karl Abshagen, Christian Peez, Arian Große-Allermann, Michael J Raschke, Oliver Riesenbeck
Format: Article
Language:English
Published: Medical Journals Sweden 2024-11-01
Series:Acta Orthopaedica
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Online Access:https://actaorthop.org/actao/article/view/42490
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author Moritz F Lodde
Christoph Katthagen
Matthias Klimek
Karl Abshagen
Christian Peez
Arian Große-Allermann
Michael J Raschke
Oliver Riesenbeck
author_facet Moritz F Lodde
Christoph Katthagen
Matthias Klimek
Karl Abshagen
Christian Peez
Arian Große-Allermann
Michael J Raschke
Oliver Riesenbeck
author_sort Moritz F Lodde
collection DOAJ
description Background and purpose: The treatment of acetabular fractures remains technically demanding. In the case of reduced bone quality or fracture morphology reducing the amount of bone available for fixation, locking plates should provide considerable advantages. The aim of the present study was to compare conventional and locking plate fixation. It was hypothesized that locking plate fixation provides less displacement and higher construct stiffness. Methods: A T-shaped acetabular fracture was simulated in 16 synthetic pelvic models. The fracture was addressed with a biplanar 10-hole 2-column plate buttressing the medial acetabular wall. Optical markers were attached to the fracture sites for motion tracking. Standardization of the acetabulum loading mechanism was performed using a unipolar hemiarthroplasty. The primary outcome measure was displacement at the fracture sites. The secondary outcome measure was the construct stiffness (N/mm). Results: Fracture displacement was less in the group of angular stable implants compared with the group fixed with conventional non-locking implants. Under cyclic loading displacement was less in the group of locking plate fixation. No differences in mean initial axial stiffness were detected between locking plate fixation (407 N/mm) and conventional plating (308 N/mm, ∆ 99 N/mm, 95% confidence interval –48 to 245). Conclusion: We showed that locking plate fixation buttressing the medial acetabular wall achieved less fracture displacement but showed no differences in axial stiffness compared with conventional plating.
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spelling doaj-art-b5f4f913441d446a94fcdea01414e2e32025-08-20T02:49:04ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822024-11-019510.2340/17453674.2024.42490Angular stable plate fixation provides favorable biomechanical stability in simulated T-shaped acetabular fractures: a biomechanical studyMoritz F Lodde0Christoph Katthagen1Matthias Klimek2Karl Abshagen3Christian Peez4https://orcid.org/0000-0001-8055-289XArian Große-Allermann5Michael J Raschke6Oliver Riesenbeck7Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, GermanyDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, GermanyDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, GermanyDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, GermanyDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, GermanyDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, GermanyDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, GermanyDepartment of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany Background and purpose: The treatment of acetabular fractures remains technically demanding. In the case of reduced bone quality or fracture morphology reducing the amount of bone available for fixation, locking plates should provide considerable advantages. The aim of the present study was to compare conventional and locking plate fixation. It was hypothesized that locking plate fixation provides less displacement and higher construct stiffness. Methods: A T-shaped acetabular fracture was simulated in 16 synthetic pelvic models. The fracture was addressed with a biplanar 10-hole 2-column plate buttressing the medial acetabular wall. Optical markers were attached to the fracture sites for motion tracking. Standardization of the acetabulum loading mechanism was performed using a unipolar hemiarthroplasty. The primary outcome measure was displacement at the fracture sites. The secondary outcome measure was the construct stiffness (N/mm). Results: Fracture displacement was less in the group of angular stable implants compared with the group fixed with conventional non-locking implants. Under cyclic loading displacement was less in the group of locking plate fixation. No differences in mean initial axial stiffness were detected between locking plate fixation (407 N/mm) and conventional plating (308 N/mm, ∆ 99 N/mm, 95% confidence interval –48 to 245). Conclusion: We showed that locking plate fixation buttressing the medial acetabular wall achieved less fracture displacement but showed no differences in axial stiffness compared with conventional plating. https://actaorthop.org/actao/article/view/42490Angular stabilityBiomechanicsFracturesOsteoporosisPelvis and acetabulum
spellingShingle Moritz F Lodde
Christoph Katthagen
Matthias Klimek
Karl Abshagen
Christian Peez
Arian Große-Allermann
Michael J Raschke
Oliver Riesenbeck
Angular stable plate fixation provides favorable biomechanical stability in simulated T-shaped acetabular fractures: a biomechanical study
Acta Orthopaedica
Angular stability
Biomechanics
Fractures
Osteoporosis
Pelvis and acetabulum
title Angular stable plate fixation provides favorable biomechanical stability in simulated T-shaped acetabular fractures: a biomechanical study
title_full Angular stable plate fixation provides favorable biomechanical stability in simulated T-shaped acetabular fractures: a biomechanical study
title_fullStr Angular stable plate fixation provides favorable biomechanical stability in simulated T-shaped acetabular fractures: a biomechanical study
title_full_unstemmed Angular stable plate fixation provides favorable biomechanical stability in simulated T-shaped acetabular fractures: a biomechanical study
title_short Angular stable plate fixation provides favorable biomechanical stability in simulated T-shaped acetabular fractures: a biomechanical study
title_sort angular stable plate fixation provides favorable biomechanical stability in simulated t shaped acetabular fractures a biomechanical study
topic Angular stability
Biomechanics
Fractures
Osteoporosis
Pelvis and acetabulum
url https://actaorthop.org/actao/article/view/42490
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AT christophkatthagen angularstableplatefixationprovidesfavorablebiomechanicalstabilityinsimulatedtshapedacetabularfracturesabiomechanicalstudy
AT matthiasklimek angularstableplatefixationprovidesfavorablebiomechanicalstabilityinsimulatedtshapedacetabularfracturesabiomechanicalstudy
AT karlabshagen angularstableplatefixationprovidesfavorablebiomechanicalstabilityinsimulatedtshapedacetabularfracturesabiomechanicalstudy
AT christianpeez angularstableplatefixationprovidesfavorablebiomechanicalstabilityinsimulatedtshapedacetabularfracturesabiomechanicalstudy
AT ariangroßeallermann angularstableplatefixationprovidesfavorablebiomechanicalstabilityinsimulatedtshapedacetabularfracturesabiomechanicalstudy
AT michaeljraschke angularstableplatefixationprovidesfavorablebiomechanicalstabilityinsimulatedtshapedacetabularfracturesabiomechanicalstudy
AT oliverriesenbeck angularstableplatefixationprovidesfavorablebiomechanicalstabilityinsimulatedtshapedacetabularfracturesabiomechanicalstudy