Vet Comp Orthop Traumatol 2021; 34(03): 171-177
DOI: 10.1055/s-0040-1718404
Original Research

Biomechanical Comparison of External Fixation and Double Plating for Stabilization of a Canine Cadaveric Supracondylar Humeral Fracture Gap Model

Sarah Castaldo
1   Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, United States
,
Jason Syrcle
1   Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, United States
,
Steve Elder
2   Agriculture and Biological Engineering, Bagley College of Engineering, Mississippi State University, Mississippi State, Mississippi, United States
,
Robert W. Wills
3   Department of Basic Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, United States
› Author Affiliations
Funding This study was partially funded by a Mississippi State University House Officer Clinical Research Grant ($2,000). Reduced-cost implants were provided by IMEX, VOI and Orthomed.

Abstract

Objective Successful stabilization of comminuted supracondylar humeral fractures is challenging, and biomechanical studies are scarce. This study compares double-plate (DB-PLATE) and linear external fixator with an intramedullary pin tie-in (ESF-IMP) fixation techniques in a cadaveric gap model. The hypothesis was the DB-PLATE construct would be stiffer, stronger and more resistant to repeated loading than the ESF-IMP construct in both cyclic and load-to-failure axial compression testing.

Study Design A 2 cm ostectomy was performed on 10 pairs of canine cadaveric humeri proximal to the supratrochlear foramen. Stabilization was with DB-PLATE (n = 10) or ESF-IMP (n = 10). Cyclic testing was performed by applying a 200 N load at 2 Hz for 63,000 cycles. Axial compressive load to failure testing followed. Data analysed included dynamic stiffness, stiffness and yield load.

Results No constructs failed during cyclic testing or lost stiffness over time. Mean dynamic stiffness over the final 100 cycles was greater for DB-PLATE compared with ESF-IMP. Mean stiffness of DB-PLATE in load-to-failure testing was not different than ESF-IMP. Yield load of DB-PLATE was higher than ESF-IMP.

Conclusion Both DB-PLATE and ESF-IMP survived cyclic testing with no change in dynamic stiffness. DB-PLATE was stronger than ESF-IMP in load-to-failure testing, which may make this construct preferable when prolonged healing or poor patient compliance is anticipated. Results suggest that either method may be appropriate for fixation of comminuted supracondylar humeral fractures.

Authors' Contributions

All the authors contributed to study conception and study design. They contributed to acquisition of data, data analysis and interpretation, drafting or revising the manuscript, and approved the submitted manuscript.




Publication History

Received: 26 November 2019

Accepted: 09 June 2020

Article published online:
16 October 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Bardet JF, Hohn RB, Rudy RL, Olmstead ML. Fractures of the humerus in dogs and cats: a retrospective study of 130 cases. Vet Surg 1983; 12: 73-77
  • 2 Vannini R, Olmstead M, Smeak D. An epidemiological study of 151 distal humeral fractures in dogs and cats. J Am Anim Hosp Assoc 1988; 24: 531-536
  • 3 Langley-Hobbs SJ. Fractures of the Humerus. In: Johnston SA, Tobias KM. eds. Veterinary Surgery: Small Animal. 2nd ed. St Louis: Elsevier; 2018: 820-835
  • 4 Turner TM. Fractures of the humerus. In: Johnson AL, Houlton JEF, Vannini R. eds. AO Principles of Fracture Management in the Dog and Cat. 1st ed.. Switzerland: AO Publishing; 2005: 201-230
  • 5 DeCamp CE, Johnston SA, Dejardin LM, Schaefer SL. Fractures of the Humerus. In: DeCamp CE, Johnston SA, Dejardin LM. et al., eds. Brinker, Piermattei and Flo's Handbook of Small Animal Orthopedics and Fracture Repair. 5th ed. Philadelphia: W.B. Saunders; 2016: 298-326
  • 6 Harari J, Roe SC, Johnson AL, Smith CW. Medial plating for the repair of middle and distal diaphyseal fractures of the humerus in dogs. Vet Surg 1986; 15: 45-48
  • 7 Vannini R, Smeak DD, Olmstead ML. Evaluation of surgical repair of 135 distal humeral fractures in dogs and cats. J Am Anim Hosp Assoc 1988; 24: 537-545
  • 8 McKee WM, Macias C, Innes JF. Bilateral fixation of Y-T humeral condyle fractures via medial and lateral approaches in 29 dogs. J Small Anim Pract 2005; 46 (05) 217-226
  • 9 Ness MG. Repair of Y-T humeral fractures in the dog using paired ‘String of Pearls’ locking plates. Vet Comp Orthop Traumatol 2009; 22 (06) 492-497
  • 10 Moffatt F, Kulendra E, Meeson RL. Repair of Y-T humeral condyle fractures with locking compression plate fixation. Vet Comp Orthop Traumatol 2019; 32 (05) 401-407
  • 11 Longley M, Chase D, Calvo I, Hall J, Langley-Hobbs SJ, Farrell M. A comparison of fixation methods for supracondylar and distal humeral shaft fractures of the dog and cat. Can Vet J 2018; 59 (12) 1299-1304
  • 12 Klause SE, Schwartz PD, Egger EL, Piermattei DL. A modification of the unilateral type I external skeletal fixator configuration for primary or secondary support of supracondylar humeral and femoral fractures. Vet Comp Orthop Traumatol 1990; 4: 130-134
  • 13 Aron DN, Foutz TL, Keller WG, Brown J. Experimental and clinical experience with an IM pin external skeletal fixator tie-in configuration. Vet Comp Orthop Traumatol 1991; 3: 86-94
  • 14 Guerin SR, Lewis DD, Lanz OI, Stalling JT. Comminuted supracondylar humeral fractures repaired with a modified type I external skeletal fixator construct. J Small Anim Pract 1998; 39 (11) 525-532
  • 15 Langley-Hobbs SJ, Carmichael S, McCartney WT. External skeletal fixation for stabilisation of comminuted humeral fractures in cats. J Small Anim Pract 1997; 38 (07) 280-285
  • 16 Beck JA, Simpson DJ. Type 1-2 hybrid external fixator with tied-in intramedullary pin for treating comminuted distal humeral fractures in a dog and a cat. Aust Vet J 1999; 77 (01) 18-20
  • 17 Au K, Mattern KL, Lewis DD. Dicondylar humeral fracture stabilisation in a dog using a transilial rod and external fixation. J Small Anim Pract 2008; 49 (03) 148-151
  • 18 Shih C-A, Su W-R, Lin W-C, Tai T-W. Parallel versus orthogonal plate osteosynthesis of adult distal humerus fractures: a meta-analysis of biomechanical studies. Int Orthop 2019; 43 (02) 449-460
  • 19 Pearson T, Glyde M, Hosgood G, Beierer L. Distal normograde intramedullary pin and locking plate placement in the canine humerus: a cadaveric study. Vet Surg 2016; 45 (07) 879-886
  • 20 Hurt RJ, Syrcle JA, Elder S, McLaughlin R. A biomechanical comparison of unilateral and bilateral String-of-Pearls™ locking plates in a canine distal humeral metaphyseal gap model. Vet Comp Orthop Traumatol 2014; 27 (03) 186-191
  • 21 Vaughn DP, Syrcle JA, Ball JE. et al. Pullout strength of monocortical and bicortical screws in metaphyseal and diaphyseal regions of the canine humerus. Vet Comp Orthop Traumatol 2016; 29 (06) 466-474
  • 22 Roush JK, McLaughlin Jr RM. Effects of subject stance time and velocity on ground reaction forces in clinically normal greyhounds at the walk. Am J Vet Res 1994; 55 (12) 1672-1676
  • 23 Budsberg SC, Verstraete MC, Soutas-Little RW. Force plate analysis of the walking gait in healthy dogs. Am J Vet Res 1987; 48 (06) 915-918
  • 24 Hottinger HA, DeCamp CE, Olivier NB, Hauptman JG, Soutas-Little RW. Noninvasive kinematic analysis of the walk in healthy large-breed dogs. Am J Vet Res 1996; 57 (03) 381-388
  • 25 Farouk O, Krettek C, Miclau T, Schandelmaier P, Guy P, Tscherne H. Minimally invasive plate osteosynthesis: does percutaneous plating disrupt femoral blood supply less than the traditional technique?. J Orthop Trauma 1999; 13 (06) 401-406