A Biomechanical Comparison of 3.5 Locking Compression Plate Fixation to 3.5 Limited Contact Dynamic Compression Plate Fixation in a Canine Cadaveric Distal Humeral Metaphyseal Gap Model

Objective- To compare the biomechanical properties of 3.5 locking compression plate (LCP) fixation to 3.5 limited contact dynamic compression plate (LC-DCP) fixation in a canine cadaveric, distal humeral metaphyseal gap model in static axial compression and cyclic axial compression and torsion.

Study Design- Biomechanical in vitro study.

Sample Population- 30 paired humeri from adult, medium to large breed dogs.

Methods- Testing was performed monotonically to failure in axial compression on ten pairs of humeri, cyclically in axial compression for 10,000 cycles on ten pairs and cyclically in torsion for 500 cycles on the last ten pairs.

Results- Humeral constructs stabilized with LCPs were significantly stiffer than those plated with LC-DCPs when loaded in axial compression (P=0.0004). When cyclically loaded in axial compression over 10,000 cycles, the LC-DCP constructs were significantly stiffer than those constructs stabilized with LCPs (P=0.0029). Constructs plated with LC-DCPs were significantly more resistant to torsion over 500 cycles than those plated with LCPs (P<0.0001), though no difference was detected during the first 280 cycles.

Conclusions- The increased stiffness of LCP constructs in monotonic loading compared to constructs stabilized with non-locking plates may be attributed to the stability afforded by the plate-screw interface of locking plates. The LCP constructs demonstrated less stiffness in dynamic testing in this model, likely due to plate-bone offset secondary to non-anatomic contouring and occasional incomplete seating of the locking screws when using the torque-limiting screw driver.

Clinical Relevance- LCPs yield less stiff fixation under dynamic loading than conventional LC-DCPs when applied to severely comminuted, metaphyseal fractures. Improving anatomical contouring of the plate and insuring complete screw insertion into the locking plate hole may improve stiffness when using LCPs in comminuted fractures.