The effects of locking inserts and overtorque on the mechanical properties of a large fragment locking compression plate

Abstract Purpose The study was to determine the effect of locking hole inserts and their insertion torque on the fatigue life of a large fragment Locking Compression Plate (LCP) under bending forces. Methods Fatigue strength of the LCP was examined using cyclic three-point bend testing at 80% yield...

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Autores principales:	Kathleen N. Meyers, Timothy S. Achor, Mark L. Prasarn, Jaimo Ahn, Kevin Khalsa, David S. Wellman, Dean G. Lorich, David L. Helfet
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Locking inserts Overtorque Mechanical testing Mechanical properties Locking plate Locking compression plate Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/6a68fa6601a64737bced01b56229c502
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spelling	oai:doaj.org-article:6a68fa6601a64737bced01b56229c5022021-11-28T12:23:36ZThe effects of locking inserts and overtorque on the mechanical properties of a large fragment locking compression plate10.1186/s40634-021-00424-02197-1153https://doaj.org/article/6a68fa6601a64737bced01b56229c5022021-11-01T00:00:00Zhttps://doi.org/10.1186/s40634-021-00424-0https://doaj.org/toc/2197-1153Abstract Purpose The study was to determine the effect of locking hole inserts and their insertion torque on the fatigue life of a large fragment Locking Compression Plate (LCP) under bending forces. Methods Fatigue strength of the LCP was examined using cyclic three-point bend testing at 80% yield strength of the construct. Locking hole inserts were used in 2, 4, and 6-hole of a 12-hole plate to simulate three different working lengths. Within each working length, plates were tested without locking inserts serving as the control group. In the experimental groups, inserts were tightened to manufacturer recommendations (4 Nm) and using overtorque (8 Nm). Results Significantly fewer cycles to failure were observed in control groups versus the locking hole insert groups for all working lengths (2-hole: 4 Nm p = 0.003, 8 Nm p = 0.003; 4-hole: 4 Nm p = 0.02, 8 Nm p < 0.001; 6-hole: 4 Nm p = 0.004, 8 Nm p < 0.001). There was a statistically significant increase in fatigue strength when using overtorque in the 4-hole (p = 0.04) and 6-hole (p = 0.01) defect groups. This was not shown in the 2-hole defect group (p = 0.99). Conclusions By placing locking inserts in the empty locking regions of Combi holes along the working length, the number of cycles to failure was increased. Tightening inserts to twice the recommended insertion torque further increased cycles to failure in longer working length models. A longer fatigue life has the potential to decease the incidence of plate failure especially in the setting of delayed union due to poor intrinsic healing capacity, fractures in the geriatric population, osteoporosis and periprosthetic fractures.Kathleen N. MeyersTimothy S. AchorMark L. PrasarnJaimo AhnKevin KhalsaDavid S. WellmanDean G. LorichDavid L. HelfetSpringerOpenarticleLocking insertsOvertorqueMechanical testingMechanical propertiesLocking plateLocking compression plateOrthopedic surgeryRD701-811ENJournal of Experimental Orthopaedics, Vol 8, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Locking inserts Overtorque Mechanical testing Mechanical properties Locking plate Locking compression plate Orthopedic surgery RD701-811
spellingShingle	Locking inserts Overtorque Mechanical testing Mechanical properties Locking plate Locking compression plate Orthopedic surgery RD701-811 Kathleen N. Meyers Timothy S. Achor Mark L. Prasarn Jaimo Ahn Kevin Khalsa David S. Wellman Dean G. Lorich David L. Helfet The effects of locking inserts and overtorque on the mechanical properties of a large fragment locking compression plate
description	Abstract Purpose The study was to determine the effect of locking hole inserts and their insertion torque on the fatigue life of a large fragment Locking Compression Plate (LCP) under bending forces. Methods Fatigue strength of the LCP was examined using cyclic three-point bend testing at 80% yield strength of the construct. Locking hole inserts were used in 2, 4, and 6-hole of a 12-hole plate to simulate three different working lengths. Within each working length, plates were tested without locking inserts serving as the control group. In the experimental groups, inserts were tightened to manufacturer recommendations (4 Nm) and using overtorque (8 Nm). Results Significantly fewer cycles to failure were observed in control groups versus the locking hole insert groups for all working lengths (2-hole: 4 Nm p = 0.003, 8 Nm p = 0.003; 4-hole: 4 Nm p = 0.02, 8 Nm p < 0.001; 6-hole: 4 Nm p = 0.004, 8 Nm p < 0.001). There was a statistically significant increase in fatigue strength when using overtorque in the 4-hole (p = 0.04) and 6-hole (p = 0.01) defect groups. This was not shown in the 2-hole defect group (p = 0.99). Conclusions By placing locking inserts in the empty locking regions of Combi holes along the working length, the number of cycles to failure was increased. Tightening inserts to twice the recommended insertion torque further increased cycles to failure in longer working length models. A longer fatigue life has the potential to decease the incidence of plate failure especially in the setting of delayed union due to poor intrinsic healing capacity, fractures in the geriatric population, osteoporosis and periprosthetic fractures.
format	article
author	Kathleen N. Meyers Timothy S. Achor Mark L. Prasarn Jaimo Ahn Kevin Khalsa David S. Wellman Dean G. Lorich David L. Helfet
author_facet	Kathleen N. Meyers Timothy S. Achor Mark L. Prasarn Jaimo Ahn Kevin Khalsa David S. Wellman Dean G. Lorich David L. Helfet
author_sort	Kathleen N. Meyers
title	The effects of locking inserts and overtorque on the mechanical properties of a large fragment locking compression plate
title_short	The effects of locking inserts and overtorque on the mechanical properties of a large fragment locking compression plate
title_full	The effects of locking inserts and overtorque on the mechanical properties of a large fragment locking compression plate
title_fullStr	The effects of locking inserts and overtorque on the mechanical properties of a large fragment locking compression plate
title_full_unstemmed	The effects of locking inserts and overtorque on the mechanical properties of a large fragment locking compression plate
title_sort	effects of locking inserts and overtorque on the mechanical properties of a large fragment locking compression plate
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/6a68fa6601a64737bced01b56229c502
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The effects of locking inserts and overtorque on the mechanical properties of a large fragment locking compression plate

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