Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Apr;6(4):216-223.
doi: 10.1302/2046-3758.64.2000470.

Externalised locking compression plate as an alternative to the unilateral external fixator: a biomechanical comparative study of axial and torsional stiffness

B F H Ang  1 , J Y Chen  2 , A K S Yew  2 , S K Chua  2 , S M Chou  3 , S L Chia  2 , J S B Koh  2 , T S Howe  2
Affiliations

Externalised locking compression plate as an alternative to the unilateral external fixator: a biomechanical comparative study of axial and torsional stiffness

B F H Ang et al. Bone Joint Res. 2017 Apr.

Abstract

Objectives: External fixators are the traditional fixation method of choice for contaminated open fractures. However, patient acceptance is low due to the high profile and therefore physical burden of the constructs. An externalised locking compression plate is a low profile alternative. However, the biomechanical differences have not been assessed. The objective of this study was to evaluate the axial and torsional stiffness of the externalised titanium locking compression plate (ET-LCP), the externalised stainless steel locking compression plate (ESS-LCP) and the unilateral external fixator (UEF).

Methods: A fracture gap model was created to simulate comminuted mid-shaft tibia fractures using synthetic composite bones. Fifteen constructs were stabilised with ET-LCP, ESS-LCP or UEF (five constructs each). The constructs were loaded under both axial and torsional directions to determine construct stiffness.

Results: The mean axial stiffness was very similar for UEF (528 N/mm) and ESS-LCP (525 N/mm), while it was slightly lower for ET-LCP (469 N/mm). One-way analysis of variance (ANOVA) testing in all three groups demonstrated no significant difference (F(2,12) = 2.057, p = 0.171).There was a significant difference in mean torsional stiffness between the UEF (0.512 Nm/degree), the ESS-LCP (0.686 Nm/degree) and the ET-LCP (0.639 Nm/degree), as determined by one-way ANOVA (F(2,12) = 6.204, p = 0.014). A Tukey post hoc test revealed that the torsional stiffness of the ESS-LCP was statistically higher than that of the UEF by 0.174 Nm/degree (p = 0.013). No catastrophic failures were observed.

Conclusion: Using the LCP as an external fixator may provide a viable and attractive alternative to the traditional UEF as its lower profile makes it more acceptable to patients, while not compromising on axial and torsional stiffness.Cite this article: B. F. H. Ang, J. Y. Chen, A. K. S. Yew, S. K. Chua, S. M. Chou, S. L. Chia, J. S. B. Koh, T. S. Howe. Externalised locking compression plate as an alternative to the unilateral external fixator: a biomechanical comparative study of axial and torsional stiffness. Bone Joint Res 2017;6:216-223. DOI: 10.1302/2046-3758.64.2000470.

Keywords: Axial stiffness; Biomechanical testing; External fixator; Externalised locking compression plate; Supercutaneous plating; Torsional stiffness.

PubMed Disclaimer

Conflict of interest statement

ICMJE Conflicts of InterestNone declared.

Figures

Fig. 1
Fig. 1
Photograph of constructs potted in dental plaster. Left: unilateral external fixator; middle: externalised stainless steel locking compression plate; right: externalised titanium locking compression plate.
Fig. 2
Fig. 2
Diagram of constructs undergoing loading.
Fig. 3
Fig. 3
Typical graph of compressive load (N) against displacement at fracture site (mm) (ET-LCP, externalised titanium locking compression plate; ESS-LCP, externalised stainless steel locking compression plate; UEF, unilateral external fixator).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Schmal H, Strohm PC, Jaeger M, Südkamp NP. Flexible fixation and fracture healing: do locked plating ‘internal fixators’ resemble external fixators? J Orthop Trauma 2011;25:S15-S20. - PubMed
    1. Qiu XS, Yuan H, Zheng X, et al. Locking plate as a definitive external fixator for treating tibial fractures with compromised soft tissue envelop. Arch Orthop Trauma Surg 2014;134:383-388. - PubMed
    1. Woon CY, Wong MK, Howe TS. LCP external fixation–external application of an internal fixator: two cases and a review of the literature. J Orthop Surg Res 2010;5:19. - PMC - PubMed
    1. Apivatthakakul T, Sananpanich K. The locking compression plate as an external fixator for bone transport in the treatment of a large distal tibial defect: a case report. Injury 2007;38:1318-1325. - PubMed
    1. Zhou Y, Wang Y, Liu L, et al. Locking compression plate as an external fixator in the treatment of closed distal tibial fractures. Int Orthop 2015;39:2227-2237. - PubMed