A locking compression plate versus the gold-standard non-locking plate with lag screw for first metatarsophalangeal fusion: A biomechanical comparison
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Authors
Mandell, DanielKarbassi, John A.
Zhou, Hanbing
Burroughs, Brian
Aurigemma, Philip
Patel, Abhay R.
UMass Chan Affiliations
Department of Orthopedics and Physical RehabilitationDocument Type
Journal ArticlePublication Date
2018-03-01Keywords
MTPFusion
Locking
Arthrodesis
Arthritis
Gold standard
Biomechanical
Fixation
Stiff
Construct
Lag
Compression
Cadaver
Toe
Mts
Orthopedics
Rehabilitation and Therapy
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Show full item recordAbstract
INTRODUCTION: The treatment of end-stage first metatarso-phalangeal joint (MTP) arthritis has been arthrodesis. A dorsal non-locking plate with a lag screw has been the standard traditional fixation method. This study compares the biomechanical strength of a locking compression plate (LCP) with and without internal compression versus this known gold standard. METHODS: In group 1, six matched pairs of cadaver great toes were used to compare the standard non-locking dorsal plate and 3.5mm lag screw to an anatomic locking compression plate in which a lag screw was utilized rather than the internal compression features of the plate. In group 2, another six matched pairs of cadaver great toes were used to compare the gold standard to the locking compression plate, utilizing the plate's internal compression feature instead of a lag screw. A material testing system (MTS) machine applied loads to the MTP joints and measured displacement and stiffness of the constructs. The stiffness of the constructs (Young's modulus) was calculated from the force-displacement curves, and the displacement was measured. RESULTS: The locking compression plate group that used the compression features of the plate, without the lag screw, had less joint displacement and higher stiffness than control (p < 0.05). The same plating construct in which a lag screw was used rather than internal compression of the plate was found to be stiffer than the control (p < 0.05), but displacement was not statistically significant. DISCUSSION: The results suggest that a locking compression plate alone provides the stiffest construct for a first MTP joint fusion.Source
Foot (Edinb). 2018 Mar;34:69-73. doi: 10.1016/j.foot.2017.11.001. Epub 2017 Nov 4. Link to article on publisher's site
DOI
10.1016/j.foot.2017.11.001Permanent Link to this Item
http://hdl.handle.net/20.500.14038/42995PubMed ID
29353123Related Resources
ae974a485f413a2113503eed53cd6c53
10.1016/j.foot.2017.11.001