The dynamisation of locking plate osteosynthesis by means of dynamic locking screws (DLS)¡ªAn experimental study in sheep
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- 作者：Michael Plecko ; Nico Lagerpusch ; Daniel Andermatt ; Robert Frigg ; Rudolf Koch ; Mich¨¨le Sidler ; Peter Kronen ; Karina Klein ; Katja Nuss ; Alex ; er B¨¹rki ; Stephen J. Ferguson ; Ulrich Stoeckle ; J?rg A. Auer ; Brigitte von Rechenberg
- 关键词：Dynamic locking screws ; Fracture healing ; Locking plate
- 刊名：Injury
- 出版年：2013
- 出版时间：October, 2013
- 年：2013
- 卷：44
- 期：10
- 页码：1346-1357
- 全文大小：2395 K
文摘
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¡ã 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 3 mm) 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 0 mm 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.