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The influence of distal screw length on the primary stability of volar plate osteosynthesis—a biomechanical study

Overview of attention for article published in Journal of Orthopaedic Surgery and Research, September 2015
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Title
The influence of distal screw length on the primary stability of volar plate osteosynthesis—a biomechanical study
Published in
Journal of Orthopaedic Surgery and Research, September 2015
DOI 10.1186/s13018-015-0283-8
Pubmed ID
Authors

Sebastian F. Baumbach, Alexander Synek, Hannes Traxler, Wolf Mutschler, Dieter Pahr, Yan Chevalier

Abstract

Extensor tendon irritation is one of the most common complications following volar locking plate osteosynthesis (VLPO) for distal radius fractures. It is most likely caused by distal screws protruding the dorsal cortex. Shorter distal screws could avoid this, yet the influence of distal screw length on the primary stability in VLPO is unknown. The aim of this study was to compare 75 to 100 % distal screw lengths in VLPO. A biomechanical study was conducted on 11 paired fresh-frozen radii. HRpQCT scans were performed to assess bone mineral density (BMD) and bone mineral content (BMC). The specimens were randomized pair-wise into two groups: 100 % (group A) and 75 % (group B) unicortical distal screw lengths. A validated fracture model for extra-articular distal radius fractures (AO-23 A3) was used. Polyaxial volar locking plates were mounted, and distal screws was inserted using a drill guide block. For group A, the distal screw tips were intended to be flush or just short of the dorsal cortex. In group B, a target screw length of 75 % was calculated. The specimens were tested to failure using a displacement-controlled axial compression test. Primary biomechanical stability was assessed by stiffness, elastic limit, and maximum force as well as with residual tilt, which quantified plastic deformation. Nine specimens were tested successfully. BMD and BMC did not differ between the two groups. The mean distal screw length of group A was 21.7 ± 2.6 mm (range: 16 to 26 mm), for group B 16.9 ± 1.9 mm (range: 12 to 20 mm). Distal screws in group B were on average 5.6 ± 0.9 mm (range: 3 to 7 mm) shorter than measured. No significant differences were found for stiffness (706 ± 103 N/mm vs. 660 ± 124 N/mm), elastic limit (177 ± 25 N vs. 167 ± 36 N), maximum force (493 ± 139 N vs. 471 ± 149 N), or residual tilt (7.3° ± 0.7° vs. 7.1° ± 1.3°). The 75 % distal screw length in VLPO provides similar primary stability to 100 % unicortical screw length. This study, for the first time, provides the biomechanical basis to choose distal screws significantly shorter then measured.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 32 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 32 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 7 22%
Other 5 16%
Student > Ph. D. Student 3 9%
Student > Postgraduate 3 9%
Professor > Associate Professor 3 9%
Other 6 19%
Unknown 5 16%
Readers by discipline Count As %
Medicine and Dentistry 16 50%
Engineering 4 13%
Physics and Astronomy 1 3%
Nursing and Health Professions 1 3%
Materials Science 1 3%
Other 1 3%
Unknown 8 25%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 September 2015.
All research outputs
#5,378,150
of 6,315,239 outputs
Outputs from Journal of Orthopaedic Surgery and Research
#285
of 324 outputs
Outputs of similar age
#156,118
of 194,890 outputs
Outputs of similar age from Journal of Orthopaedic Surgery and Research
#25
of 32 outputs
Altmetric has tracked 6,315,239 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 324 research outputs from this source. They receive a mean Attention Score of 2.2. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 194,890 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 32 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.