The dynamic locking screw (DLS) can increase interfragmentary motion on the near cortex of locked plating constructs by reducing the axial stiffness

Background The plate–screw interface of an angular stable plate osteosynthesis is very rigid. So far, all attempts to decrease the stiffness of locked plating construct, e.g. the bridged plate technique, decrease primarily the bending stiffness. Thus, the interfragmentary motion increases only on th...

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Published in:	Langenbeck's archives of surgery Vol. 395; no. 4; pp. 421 - 428
Main Authors:	Döbele, Stefan, Horn, Carsten, Eichhorn, Stefan, Buchholtz, Arne, Lenich, Andreas, Burgkart, Rainer, Nüssler, Andreas K., Lucke, Martin, Andermatt, Daniel, Koch, Rudolf, Stöckle, Ulrich
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer-Verlag 01-04-2010
Subjects:	Abdominal Surgery Biomechanical Phenomena Bone Plates Bone Screws Cardiac Surgery Fracture Fixation, Internal - instrumentation Fracture Healing Fractures, Bone - surgery General Surgery Humans Medicine Medicine & Public Health Models, Biological Original Article Thoracic Surgery Tibial Fractures - surgery Traumatic Surgery Vascular Surgery Dynamic locking screw Interfragmentary motion Locking compression plate Locking screws Stiffness reduction
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Summary:	Background The plate–screw interface of an angular stable plate osteosynthesis is very rigid. So far, all attempts to decrease the stiffness of locked plating construct, e.g. the bridged plate technique, decrease primarily the bending stiffness. Thus, the interfragmentary motion increases only on the far cortical side by bending the plate. To solve this problem, the dynamic locking screw (DLS) was developed. Materials and methods Comparison tests were performed with locking screws (LS) and DLS. Axial stiffness, bending stiffness and interfragmentary motion were compared. For measurements, we used a simplified transverse fracture model, consisting of POM C and an 11-hole LCP3.5 with a fracture gap of 3 mm. Three-dimensional fracture motion was detected using an optical measurement device (PONTOS 5 M/GOM) consisting of two CCD cameras (2,448 × 2,048 pixel) observing passive markers. Results The DLS reduced the axial stiffness by approximately 16% while increasing the interfragmentary motion at the near cortical side significantly from 282 µm (LS) to 423 µm (DLS) applying an axial load of 150 N. Conclusion The use of DLS reduces the stiffness of the plate–screw interface and thus increases the interfragmentary motion at the near cortical side without altering the advantages of angular stability and the strength.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1435-2443 1435-2451
DOI:	10.1007/s00423-010-0636-z