Biomechanical Comparison of Titanium Locking Fragment-Specific and Volar Locking Plates for AO B1 and B2 Fractures of the Distal Radius

Purpose This biomechanical study compared the stability of volar locking plates (VLPs) and locking fragment-specific (LFS) dorsal and radial styloid plates for the fixation of dorsal (AO 23-B2) and radial styloid (AO 23-B1) shear fractures of the distal radius, respectively. Methods Two groups of 6 composite radii were fixed with a VLP or an LFS dorsal plate over a simulated dorsal shear fracture. Two additional groups of 6 radii received the same VLP or an LFS radial plate to fix a radial styloid fracture. Each plated radius was tested under cyclic axial compression by a servohydraulic testing machine that recorded axial displacement per cycle. Construct stiffness was calculated from the slope of the force-displacement curve. Results In the dorsal shear fracture model, the dorsal LFS plate exhibited less displacement than the VLP (0.32 +/- 0.04 vs 0.43 +/- 0.07 mm, respectively) and showed greater average stiffness (645 +/- 64 vs 433 +/- 88 N/mm, respectively). Plate type was responsible for 53.1% of the variation in displacement and 68.6% of the variation in stiffness. In the radial styloid fracture model, variations due to number of cycles elapsed and plate type were similar for displacement and stiffness in both groups. The average stiffness during cyclical nondestructive testing was 566 +/- 45 and 573 +/- 60 N/mm for VLP and LFS radial plating groups, respectively. Conclusions For AO 23-B2 (dorsal rim) fractures, the dorsal LFS plates exhibited significantly less displacement and greater stiffness in axial loading than VLPs. ForAO23-B1 (radial styloid) fractures, the VLP displayed similar displacement and stiffness to the radial LFS plates. Copyright (C) 2019 by the American Society for Surgery of the Hand. All rights reserved.