Summary
Objectives: To evaluate the effect of varying the number and configuration of locking bicortical
and monocortical screws on a plate-rod construct using a mid-diaphyseal femoral ostectomy
model.
Methods: Thirty Greyhound femurs were assigned to six groups (A-F). An intramedullary pin
was placed in each bone following which a 3.5 mm locking plate was applied with six
differing locking screw configurations. Groups A to C had one bicortical screw in
the most proximal and distal plate holes and one to three monocortical locking screws
in the proximal and distal fragments. Groups D to F had no bicortical screws placed
and two to four monocortical locking screws in proximal and distal fragments. Each
construct was axially loaded at 4 Hz from a preload of 10 Newtons (N) to 72 N, increasing
to 144 N and 216 N, each of 6000 cycles with a further 45,000 cycles at 216 N to simulate
a three to six week postoperative convalescence period. Constructs were then loaded
to failure.
Results: No construct suffered screw loosening or a significant change in construct stiffness
during cyclic loading. There was no significant difference in load to failure of any
construct (p = 0.34), however, less variation was seen with monocortical constructs.
All constructs failed at greater than 2.5 times physiological load, and failure was
by bending of the intramedullary pin and plate rather than screw loosening or pull-out.
Clinical significance: Axially loaded locking monocortical plate-rod constructs applied to the canine femur
may confer no difference biomechanically to those employing locking bicortical screws.
Keywords
Plate-rod - comminuted fracture - monocortical locking screws - bicortical locking
screws