Header

UZH-Logo

Maintenance Infos

The dynamisation of locking plate osteosynthesis by means of dynamic locking screws (DLS)-An experimental study in sheep


Plecko, Michael; Lagerpusch, Nico; Andermatt, Daniel; Frigg, Robert; Koch, Rudolf; Sidler, Michèle; Kronen, Peter W; Klein, Karina; Nuss, Katja M; Bürki, Alexander; Ferguson, Stephen J; Stoeckle, Ulrich; Auer, Jörg A; von Rechenberg, Brigitte (2013). The dynamisation of locking plate osteosynthesis by means of dynamic locking screws (DLS)-An experimental study in sheep. Injury, 44(10):1346-1357.

Abstract

In this in vivo study a new generation of locking screws was tested. The design of the dynamic locking screw (DLS) enables the dynamisation of the cortex underneath the plate (cis-cortex) and, therefore, allows almost parallel interfragmentary closure of the fracture gap. A 45° angle osteotomy was performed unilaterally on the tibia of 37 sheep. Groups of 12 sheep were formed and in each group a different osteotomy gap (0, 1 and 3mm) was fixed using a locking compression plate (LCP) in combination with the DLS. The healing process was monitored radiographically every 3 weeks for 6, respectively 12 weeks. After this time the sheep were sacrificed, the bones harvested and the implants removed. The isolated bones were evaluated in the micro-computed tomography unit, tested biomechanically and evaluated histologically. The best results of interfragmentary movement (IFM) were shown in the 0mm configuration. The bones of this group demonstrated histomorphometrically the most distinct callus formation on the cis-cortex and the highest torsional stiffness relative to the untreated limb at 12 weeks after surgery. This animal study showed that IFM stimulated the synthesis of new bone matrix, especially underneath the plate and thus, could solve a current limitation in normal human bone healing. The DLS will be a valuable addition to the locking screw technology and improve fracture healing.

Abstract

In this in vivo study a new generation of locking screws was tested. The design of the dynamic locking screw (DLS) enables the dynamisation of the cortex underneath the plate (cis-cortex) and, therefore, allows almost parallel interfragmentary closure of the fracture gap. A 45° angle osteotomy was performed unilaterally on the tibia of 37 sheep. Groups of 12 sheep were formed and in each group a different osteotomy gap (0, 1 and 3mm) was fixed using a locking compression plate (LCP) in combination with the DLS. The healing process was monitored radiographically every 3 weeks for 6, respectively 12 weeks. After this time the sheep were sacrificed, the bones harvested and the implants removed. The isolated bones were evaluated in the micro-computed tomography unit, tested biomechanically and evaluated histologically. The best results of interfragmentary movement (IFM) were shown in the 0mm configuration. The bones of this group demonstrated histomorphometrically the most distinct callus formation on the cis-cortex and the highest torsional stiffness relative to the untreated limb at 12 weeks after surgery. This animal study showed that IFM stimulated the synthesis of new bone matrix, especially underneath the plate and thus, could solve a current limitation in normal human bone healing. The DLS will be a valuable addition to the locking screw technology and improve fracture healing.

Statistics

Citations

11 citations in Web of Science®
14 citations in Scopus®
Google Scholar™

Altmetrics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Trauma Surgery
05 Vetsuisse Faculty > Veterinary Clinic > Equine Department
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2013
Deposited On:21 Feb 2013 13:49
Last Modified:05 Jan 2017 14:49
Publisher:Elsevier
ISSN:0020-1383
Publisher DOI:https://doi.org/10.1016/j.injury.2012.10.022
PubMed ID:23182750

Download

Full text not available from this repository.
View at publisher