Treatment of comminuted metaphyseal distal femoral fractures with a micromotion-balancing osteosynthesis: an animal study

BMC Surgery

Research

Zhengwei Duan¹  Diankai Wang²  Hao Hu²  Hua Lu²  Yang Wang² 

[1] Department of Orthopaedics, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, 200092, Shanghai, China;Department of Orthopaedics, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine Chongming Branch, 202150, Shanghai, China;

关键词: Novel drill;    Locking plate;    Distal femoral fracture;    Fracture healing;    Animal experiments;   

DOI  :  10.1186/s12893-023-01939-2

 received in 2022-12-05, accepted in 2023-02-13,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundLocking plates are commonly used in the treatment of comminuted metaphyseal distal femoral fractures. However, locking plates form a strong structure and promote asymmetrical callus formation, which is not conducive for rapid fracture healing and may increase fracture risk. To overcome this, we designed a micromotion-balancing fixation system based on locking plates.MethodsSix healthy pigs (Bama miniature pigs) were used to establish a model of bilateral comminuted distal femoral fracture (AO/ASIF: 33-C2). Standard drilling was performed on one of each pig’s hind limbs (control group), whereas eccentric drilling was performed on the other hind limb (experimental group). Both femurs were fixed with a 3-hole locking compression plate using 5-mm-diameter screws. At 12 postoperative weeks, all pigs were euthanized and the femurs with compression plates were radiographically examined. The level of fracture healing and loosening/internal fixation failure were recorded. Bone mineral density, number of trabeculae, trabecular morphology, and calcification precipitations were assessed.ResultsAll pigs survived, and the fractures healed. No complications related to fracture healing, such as infection and internal fixation failure, were noted. The bone mineral density of the near and far cortical calli, number of the near and far cortical callus trabeculae, and difference in bone mineral density between the near and far cortical calli in the experimental group were significantly higher than those in the control group (p < 0.01). However, the difference in the number of trabeculae between the near and far cortical calli was significantly lower in the experimental group than in the control group (p < 0.01).ConclusionThis newly designed system provides stable fixation for comminuted distal femoral fracture, increases the overall strain at the fracture site, and balances the strains at the near and far cortices to achieve uniform callus growth and fracture healing.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

41116_2023_36_Article_IEq431.gif

41116_2023_36_Article_IEq427.gif

41116_2023_36_Article_IEq425.gif

41116_2023_36_Article_IEq424.gif

41116_2023_36_Article_IEq420.gif

41116_2023_36_Article_IEq417.gif

41116_2023_36_Article_IEq414.gif

41116_2023_36_Article_IEq410.gif

Fig. 2

41116_2023_36_Article_IEq345.gif