Do locking screws work in plates bent at holes?

Abstract:

OBJECTIVES:To assess whether plate bending at a hole significantly changes the biomechanical properties of a locked screw. METHODS:Coronal plane bends of 5-, 15-, or 45-degree angles were placed in 3.5-mm locking compression plates with the apex at a locking hole. An additional 45-degree angle test group was created in which a threaded screw head insert was placed before bending. Ten plates were tested in each group and compared with nonbent controls in a stepwise cyclic loading protocol. RESULTS:Statistically significant differences in protocol survival were shown between the control group and the 15-degree angle (P = 0.006) and 45-degree angle (P = 0.0007) groups. An apparent decrease in protocol survival in the 5-degree angle group did not reach statistical significance (P = 0.17). The average number of cycles survived was significantly different between the control group and the 15-degree angle (P = 0.027) and 45-degree angle (P = 0.0002) groups. The mean cycles to failure for the 5-degree angle group was 16% lower than for controls but did not reach statistical significance (P = 0.37). The test group bent to an angle of 45 degrees after placement of a threaded screw head insert showed no difference in protocol survival or in mean number of cycles survived compared with the regular 45-degree angle group. CONCLUSION:Bending of a 3.5-mm locking compression plate by more than 5 degrees at a locking hole results in a statistically significant decrease in survival of the corresponding locked screw. This effect cannot be prevented by the placement of a threaded screw head insert before bending.

journal_name

J Orthop Trauma

authors

Boulton CL,Kim H,Shah SB,Ryan SP,Metzger TA,Hsieh AH,O'Toole RV

doi

10.1097/BOT.0b013e3182a73a77

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

189-94

issue

4

eissn

0890-5339

issn

1531-2291

journal_volume

28

pub_type

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