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J Wrist Surg 2020; 9(06): 475-480
DOI: 10.1055/s-0040-1713419
Scientific Article

Bridge Plate Design Effects on Yield and Fatigue in Distal Radius Fracture Model

Asif M. Ilyas
1   Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania
,
Gerald M. Hayward II
2   Musculoskeletal Education and Research Center (MERC), A Division of Globus Medical Inc., Audubon, Pennsylvania
,
Jonathan A. Harris
2   Musculoskeletal Education and Research Center (MERC), A Division of Globus Medical Inc., Audubon, Pennsylvania
,
Wenhai Wang
2   Musculoskeletal Education and Research Center (MERC), A Division of Globus Medical Inc., Audubon, Pennsylvania
,
Brandon S. Bucklen
2   Musculoskeletal Education and Research Center (MERC), A Division of Globus Medical Inc., Audubon, Pennsylvania
› Author Affiliations Funding G. M. H., J. A. H., W. W., and B. S. B. are salaried employees of Globus Medical Inc. and hold associated stock and stock options. Study-related costs (i.e., material procurement) were allocated from the research budget of MERC, a division of Globus Medical Inc., but no direct grant was provided.
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Abstract

Background Bridge plating for distal radius fractures is indicated for complex fractures with comminution, extensive articular involvement, and/or cases requiring immediate weight bearing. Bridge plate fixation of distal radius fractures is a well-documented treatment method; however, failures have been reported with repetitive loading through the bridged distal radius fracture. Plate design is implicated as a cause of plate fracture in select clinical studies but few mechanical tests comparing bridge plate designs have been reported. This study sought to determine the impact of plate design on bridge plates intended to allow for immediate weight-bearing.

Methods Axial static (n = 3) and dynamic testing (n = 3) was performed on three distraction plates designs: bridge plate 1 (BP1) with central holes, bridge plate 2 (BP2) without central holes, and locking compression plate (BP3). Plates were loaded in axial compression with a simulated 10-mm fracture gap.

Results Significant static load differences were noted between all groups. Static load to failure for BP1, BP3, and BP2 were 240 ± 5 N, 398 ± 9 N, and 420 ± 3 N, respectively (p < 0.05). BP1 was the only plate series that failed during dynamic testing; all other plates achieved 100,000 cycles. Failure mode was a fracture occurring through the central screw hole of BP1. Finite element analysis demonstrated the effects of central screw holes on stress, strain, and plastic deformation under loading.

Conclusion Unused screw holes are the mechanical weak points; plates designed without these central screw holes are expected to survive greater load values. The threshold for clinical importance will need to be determined by future studies.

Keywords

bridge plating - distal radius fracture - mechanical testing - locking compression plate - trauma

Ethical Approval

This article does not contain any studies with human or animal subjects, so Ethical Review Committee approval was not required.


Note

The study was performed at MERC, Audubon, Pennsylvania.




Publication History

Received: 13 June 2019

Accepted: 07 May 2020

Article published online:
06 July 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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