Plaque palmaire dans les fractures distales du radius : étude bio-mécanique comparée des plaques en acier, en titane et en fibre de carbone renforcée au polyetheretherketone - 27/09/18
Biomechanical comparison between stainless steel, titanium and carbon-fiber reinforced polyetheretherketone volar locking plates for distal radius fractures
, Luigi Tarallo b, Francesco Capra c, Fabio Catani bAbstract |
Introduction |
As the popularity of volar locked plate fixation for distal radius fractures has increased, so have the number and variety of implants, including variations in plate design, the size and angle of the screws, the locking screw mechanism, and the material of the plates.
Hypothesis |
Carbon-fiber reinforced polyetheretherketone (CFR-PEEK) plate features similar biomechanical properties to metallic plates, representing, therefore, an optimal alternative for the treatment of distal radius fractures.
Materials and methods |
Three different materials-composed plates were evaluated: stainless steel volar lateral column (Zimmer); titanium DVR (Hand Innovations); CFR-PEEK DiPHOS-RM (Lima Corporate). Six plates for each type were implanted in sawbones and an extra-articular rectangular osteotomy was created. Three plates for each material were tested for load to failure and bending stiffness in axial compression. Moreover, 3 constructs for each plate were evaluated after dynamically loading for 6000 cycles of fatigue.
Results |
The mean bending stiffness pre-fatigue was significantly higher for the stainless steel plate. The titanium plate yielded the higher load to failure both pre and post fatigue. After cyclic loading, the bending stiffness increased by a mean of 24% for the stainless steel plate; 33% for the titanium; and 17% for the CFR-PEEK plate. The mean load to failure post-fatigue increased by a mean of 10% for the stainless steel and 14% for CFR-PEEK plates, whereas it decreased (−16%) for the titanium plate. Statistical analysis between groups reported significant values (P<001) for all comparisons except for Hand Innovations vs. Zimmer bending stiffness post fatigue (P=0.197).
Discussion |
The significant higher load to failure of the titanium plate, makes it indicated for patients with higher functional requirements or at higher risk of trauma in the postoperative period. The CFR-PEEK plate showed material-specific disadvantages, represented by little tolerance to plastic deformation, and lower load to failure.
Level of evidence |
N/A.
Le texte complet de cet article est disponible en PDF.Keywords : Distal radius, Plate, Bending stiffness, Load to failure, Biomechanical, Material
| ☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology : Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus. |
Vol 104 - N° 6
P. 602 - octobre 2018 Retour au numéro
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