Biomechanical Comparison of Two Locking Plate Constructs for the Stabilization of Feline Tibial FracturesFunding This study received funding from Boehringer Ingelheim Veterinary Scholars Program; Discretionary Funds from the University of Florida Comparative Orthopedics and Biomechanics Laboratory, Gainesville, FL.
16 September 2018
27 September 2019
13 December 2019 (online)
Objectives The aim of this study was to compare the biomechanical characteristics of locking compression plate (LCP) and conical coupling plate (CCP) constructs for the stabilization of experimentally induced gap fractures in cat tibiae.
Materials and Methods Pelvic limbs were harvested from eight cat cadavers. Paired tibiae were stripped of all soft tissues, and randomly assigned to the LCP or CCP stabilization group. An eight-hole 2.7 mm LCP or a six-hole 2.5 mm CCP was applied to the medial surface of each tibia. A 1-cm segment of the tibia was excised centrally beneath the plate. The specimens were potted, then tested in non-destructive four-point craniocaudal and mediolateral bending, followed by non-destructive axial compression. Each construct was subsequently loaded to failure in axial compression. Bending and axial stiffness, yield load and failure load were calculated for each specimen.
Results The LCP constructs were significantly stiffer than the CCP constructs when subjected to non-destructive bending and axial loading. Craniocaudal bending stiffness was significantly greater than mediolateral bending stiffness for both constructs. Yield load and failure load were significantly greater for LCP constructs compared with CCP constructs.
Clinical Significance LCP may be a more suitable implant for stabilizing complex diaphyseal tibial fractures in cats. Additional supplemental fixation should be considered when using CCP to stabilize unreconstructed diaphyseal tibial fractures in cats. Further clinical investigation of both implants is recommended.
Natasha M. Hottmann and David Tuyn contributed to study design, acquisition of data and data analysis and interpretation. Matthew D. Johnson and Daniel D. Lewis contributed to conception of study, study design and data analysis and interpretation. Scott A. Banks contributed to study design and data analysis and interpretation. All authors drafted, revised and approved the submitted manuscript.
- 1 Nolte DM, Fusco JV, Peterson ME. Incidence of and predisposing factors for nonunion of fractures involving the appendicular skeleton in cats: 18 cases (1998-2002). J Am Vet Med Assoc 2005; 226 (01) 77-82
- 2 McCartney WT, MacDonald BJ. Incidence of non-union in long bone fractures in 233 cats. Int J Appl Res Vet Med 2006; 4 (03) 209-212
- 3 Morris AP, Anderson AA, Barnes DM. , et al. Plate failure by bending following tibial fracture stabilisation in 10 cats. J Small Anim Pract 2016; 57 (09) 472-478
- 4 Boone EG, Johnson AL, Montavon P, Hohn RB. Fractures of the tibial diaphysis in dogs and cats. J Am Vet Med Assoc 1986; 188 (01) 41-45
- 5 Richardson EF, Thatcher CW. Tibial fractures in cats. Comp Cont Educ Pract 1993; 15 (03) 383-394
- 6 Perry KL, Bruce M. Impact of fixation method on postoperative complication rates following surgical stabilization of diaphyseal tibial fractures in cats. Vet Comp Orthop Traumatol 2015; 28 (02) 109-115
- 7 Gemmill TJ, Cave TA, Clements DN, Clarke SP, Bennett D, Carmichael S. Treatment of canine and feline diaphyseal radial and tibial fractures with low-stiffness external skeletal fixation. J Small Anim Pract 2004; 45 (02) 85-91
- 8 Reems MR, Beale BS, Hulse DA. Use of a plate-rod construct and principles of biological osteosynthesis for repair of diaphyseal fractures in dogs and cats: 47 cases (1994-2001). J Am Vet Med Assoc 2003; 223 (03) 330-335
- 9 Demner D, Garcia TC, Serdy MG, Hayashi K, Nir BA, Stover SM. Biomechanical comparison of mono- and bicortical screws in an experimentally induced gap fracture. Vet Comp Orthop Traumatol 2014; 27 (06) 422-429
- 10 Rowe-Guthrie KM, Markel MD, Bleedorn JA. Mechanical evaluation of locking, nonlocking, and hybrid plating constructs using a locking compression plate in a canine synthetic bone model. Vet Surg 2015; 44 (07) 838-842
- 11 Petazzoni M, Urizzi A, Verdonck B, Jaeger G. Fixin internal fixator: concept and technique. Vet Comp Orthop Traumatol 2010; 23 (04) 250-253
- 12 Wagner M. General principles for the clinical use of the LCP. Injury 2003; 34 (Suppl. 02) B31-B42
- 13 Gervais B, Vadean A, Raison M, Brochu M. Failure analysis of a 316L stainless steel femoral orthopedic implant. Case Stud Eng Fail Anal 2016; 5–6: 30-38
- 14 Levine DG, Richardson DW. Clinical use of the locking compression plate (LCP) in horses: a retrospective study of 31 cases (2004-2006). Equine Vet J 2007; 39 (05) 401-406
- 15 Blake CA, Boudrieau RJ, Torrance BS. , et al. Single cycle to failure in bending of three standard and five locking plates and plate constructs. Vet Comp Orthop Traumatol 2011; 24 (06) 408-417
- 16 Perren SM. Backgrounds of the technology of internal fixators. Injury 2003; 34 (Suppl. 02) B1-B3
- 17 Beale BS, McCally R. Minimally invasive plate osteosynthesis: tibia and fibula. Vet Clin North Am Small Anim Pract 2012; 42 (05) 1023-1044 , vii
- 18 Tremolada G, Lewis DD, Paragnani KL, Conrad BP, Kim SE, Pozzi A. Biomechanical comparison of a 3.5-mm conical coupling plating system and a 3.5-mm locking compression plate applied as plate-rod constructs to an experimentally created fracture gap in femurs of canine cadavers. Am J Vet Res 2017; 78 (06) 712-717
- 19 van der Zee J. In vitro biomechanical comparison of the effects of cerclage wires, an intramedullary pin and the combination thereof on an oblique osteotomy of the canine tibia. Vet Comp Orthop Traumatol 2014; 27 (02) 91-96
- 20 Nicetto T, Petazzoni M, Urizzi A, Isola M. Experiences using the Fixin locking plate system for the stabilization of appendicular fractures in dogs: a clinical and radiographic retrospective assessment. Vet Comp Orthop Traumatol 2013; 26 (01) 61-68
- 21 Brinker WO, Olmstead ML, Sumner-Smith G, Prieur WD. , Eds. Manual of internal fixation in small animals. 2nd edition. Berlin, Germany: Springer-Verlag Berlin and Heidelberg GmbH & Co. KG; 1998
- 22 Brand Jr J, Hamilton D, Selby J, Pienkowski D, Caborn DN, Johnson DL. Biomechanical comparison of quadriceps tendon fixation with patellar tendon bone plug interference fixation in cruciate ligament reconstruction. Arthroscopy 2000; 16 (08) 805-812
- 23 Preston TJ, Glyde M, Hosgood G, Day RE. Dual bone fixation: a biomechanical comparison of 3 implant constructs in a mid-diaphyseal fracture model of the feline radius and ulna. Vet Surg 2016; 45 (03) 289-294
- 24 Uhl JM, Kapatkin AS, Garcia TC, Stover SM. Ex vivo biomechanical comparison of a 3.5 mm locking compression plate applied cranially and a 2.7 mm locking compression plate applied medially in a gap model of the distal aspect of the canine radius. Vet Surg 2013; 42 (07) 840-846
- 25 Coggeshall JD, Lewis DD, Iorgulescu A, Kim SE, Palm LS, Pozzi A. Adjunct fixation with a Kirschner wire or a plate for lateral unicondylar humeral fracture stabilization. Vet Surg 2017; 46 (07) 933-941
- 26 DeTora M, Kraus K. Mechanical testing of 3.5 mm locking and non-locking bone plates. Vet Comp Orthop Traumatol 2008; 21 (04) 318-322
- 27 Schmökel HG, Stein S, Radke H, Hurter K, Schawalder P. Treatment of tibial fractures with plates using minimally invasive percutaneous osteosynthesis in dogs and cats. J Small Anim Pract 2007; 48 (03) 157-160
- 28 Stoffel K, Dieter U, Stachowiak G, Gächter A, Kuster MS. Biomechanical testing of the LCP--how can stability in locked internal fixators be controlled?. Injury 2003; 34 (Suppl. 02) B11-B19
- 29 Chao P, Conrad BP, Lewis DD, Horodyski M, Pozzi A. Effect of plate working length on plate stiffness and cyclic fatigue life in a cadaveric femoral fracture gap model stabilized with a 12-hole 2.4 mm locking compression plate. BMC Vet Res 2013; 9 (01) 125-134
- 30 Hoffmeier KL, Hofmann GO, Mückley T. Choosing a proper working length can improve the lifespan of locked plates. A biomechanical study. Clin Biomech (Bristol, Avon) 2011; 26 (04) 405-409
- 31 Bilmont A, Palierne S, Verset M, Swider P, Autefage A. Biomechanical comparison of two locking plate constructs under cyclic torsional loading in a fracture gap model. Two screws versus three screws per fragment. Vet Comp Orthop Traumatol 2015; 28 (05) 323-330
- 32 Palierne S, Froidefond B, Swider P, Autefage A. Biomechanical comparison of two locking plate constructs under cyclic loading in four-point bending in a fracture gap model: two screws versus three screws per fragment. Vet Comp Orthop Traumatol 2019; 32 (01) 59-66
- 33 Ahmad M, Nanda R, Bajwa AS, Candal-Couto J, Green S, Hui AC. Biomechanical testing of the locking compression plate: when does the distance between bone and implant significantly reduce construct stability?. Injury 2007; 38 (03) 358-364
- 34 Blauth M, Minehara H, Pesantez R, Shoda E, Sommer C. Trauma, Lower Extremity. AOTK System Innovations; Switzerland: AO Foundation; 2016: 13
- 35 Disegi J. Materials Used for AO Implants - An Overview and Outlook. New Products from AO Development; Switzerland: AO Publishing; 2003: 2-4
- 36 Rotne R, Bertollo N, Walsh W, Dhand NK, Voss K, Johnson KA. Influence of plate-bone contact on cyclically loaded conically coupled locking plate failure. Injury 2014; 45 (03) 515-521
- 37 Sarrau S, Meige F, Autefage A. Treatment of femoral and tibial fractures in puppies by elastic plate osteosynthesis. A review of 17 cases. Vet Comp Orthop Traumatol 2007; 20 (01) 51-58
- 38 Cabassu JP. Elastic plate osteosynthesis of femoral shaft fractures in young dogs. Vet Comp Orthop Traumatol 2001; 14 (01) 40-45
- 39 Rutherford S, Demianiuk RM, Benamou J, Beckett C, Ness MG, Déjardin LM. Effect of intramedullary rod diameter on a string of pearls plate-rod construct in mediolateral bending: an in vitro mechanical study. Vet Surg 2015; 44 (06) 737-743
- 40 Craig A, Witte PG, Moody T, Harris K, Scott HW. Management of feline tibial diaphyseal fractures using orthogonal plates performed via minimally invasive plate osteosynthesis. J Feline Med Surg 2018; 20 (01) 6-14