Far Cortical Locking Can Improve Healing of Fractures Stabilized with Locking Plates

• DOI: 10.2106/jbjs.i.01111
• Publication Date: 2010-07-01T17:53:07Z
• Authors: Michael Bottlang; Maren Lesser; Julia Koerber; Josef Doornink; Brigitte von Rech...; Peter Augat; Daniel C. Fitzpat...; Steven M. Madey; J. Lawrence Marsh
• Keywords: Callus; Plating (geology)

Locked bridge plating relies on secondary bone healing, which requires interfragmentary motion for callus formation. This study evaluated healing of fractures stabilized with a locked construct and far cortical locking construct, is modified approach that promotes motion. The tested whether constructs can improve fracture-healing compared standard constructs.In an established ovine tibial osteotomy model 3-mm gap size, twelve osteotomies were randomly or applied medially. designed to provide 84% lower stiffness than the permitted nearly parallel Fracture-healing was monitored weekly radiographs. After animals killed at week 9, healed tibiae analyzed by computed tomography, mechanical testing in torsion, histological examination.Callus radiographs greater constructs. At group had 36% volume (p = 0.03) 44% higher mineral content 0.013) group. Callus specimens asymmetric, having 49% less medial lateral 0.003). In specimens, similar 0.91). be 54% stronger torsion 0.023) sustained 156% energy failure < 0.001) specimens. Histologically, three six deficient bridging across cortex, while all remaining cortices bridged.Inconsistent asymmetric formation likely due their high closure. By providing flexible fixation motion, form more heal