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Variable fixation promotes callus formation: an experimental study on transverse tibial osteotomies stabilized with locking plates

BACKGROUND: A new locking screw technology, named variable fixation, has been developed aiming at promoting bone callus formation providing initial rigid fixation followed by progressive fracture gap dynamisation. In this study, we compared bone callus formation in osteotomies stabilized with standa...

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Autores principales: Plecko, Michael, Klein, Karina, Planzer, Katrin, Wähnert, Dirk, Behm, Pascal, Ferguson, Stephen J., Brianza, Stefano, Stadelmann, Vincent A., von Rechenberg, Brigitte
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7713143/
https://www.ncbi.nlm.nih.gov/pubmed/33272239
http://dx.doi.org/10.1186/s12891-020-03781-6
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author Plecko, Michael
Klein, Karina
Planzer, Katrin
Wähnert, Dirk
Behm, Pascal
Ferguson, Stephen J.
Brianza, Stefano
Stadelmann, Vincent A.
von Rechenberg, Brigitte
author_facet Plecko, Michael
Klein, Karina
Planzer, Katrin
Wähnert, Dirk
Behm, Pascal
Ferguson, Stephen J.
Brianza, Stefano
Stadelmann, Vincent A.
von Rechenberg, Brigitte
author_sort Plecko, Michael
collection PubMed
description BACKGROUND: A new locking screw technology, named variable fixation, has been developed aiming at promoting bone callus formation providing initial rigid fixation followed by progressive fracture gap dynamisation. In this study, we compared bone callus formation in osteotomies stabilized with standard locking fixation against that of osteotomies stabilized with variable fixation in an established tibia ovine model. METHODS: A 3 mm tibial transverse osteotomy gap was stabilized in three groups of six female sheep each with a locking plate and either 1) standard fixation in both segments (group LS) or 2) variable fixation in the proximal and standard fixation in the distal bone segment (group VFLS(3)) or 3) variable fixation in both segments (group VFLS(6)). The implantation site and fracture healing were compared between groups by means of radiologic, micro tomographic, biomechanical, and histological investigations. RESULTS: Compared to LS callus, VFLS(3) callus was 40% larger and about 3% denser, while VFLS(6) callus was 93% larger and its density about 7.2% lower. VFLS(3) showed 65% and VFLS(6) 163% larger amount of callus at the cis-cortex. There wasn’t a significant difference in the amount of callus at the cis and trans-cortex in groups featuring variable fixation only. Investigated biomechanical variables were not significantly different among groups and histology showed comparable good healing in all groups. Tissues adjacent to the implants did not show any alteration of the normal structure in all groups. CONCLUSIONS: Variable fixation promoted the formation of a larger amount of bone callus, equally distributed at the cis and trans cortices. The histological and biomechanical properties of the variable fixation callus were equivalent to those of the standard fixation callus. The magnitude of variable fixation had a biological effect on the formation of bone callus. At the implantation site, the usage of variable fixation did not raise additional concerns with respect to standard fixation. The formation of a larger amount of mature callus suggests that fractures treated with variable fixation might have a higher probability to bridge the fracture gap. The conditions where its usage can be most beneficial for patients needs to be clinically defined.
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spelling pubmed-77131432020-12-03 Variable fixation promotes callus formation: an experimental study on transverse tibial osteotomies stabilized with locking plates Plecko, Michael Klein, Karina Planzer, Katrin Wähnert, Dirk Behm, Pascal Ferguson, Stephen J. Brianza, Stefano Stadelmann, Vincent A. von Rechenberg, Brigitte BMC Musculoskelet Disord Research Article BACKGROUND: A new locking screw technology, named variable fixation, has been developed aiming at promoting bone callus formation providing initial rigid fixation followed by progressive fracture gap dynamisation. In this study, we compared bone callus formation in osteotomies stabilized with standard locking fixation against that of osteotomies stabilized with variable fixation in an established tibia ovine model. METHODS: A 3 mm tibial transverse osteotomy gap was stabilized in three groups of six female sheep each with a locking plate and either 1) standard fixation in both segments (group LS) or 2) variable fixation in the proximal and standard fixation in the distal bone segment (group VFLS(3)) or 3) variable fixation in both segments (group VFLS(6)). The implantation site and fracture healing were compared between groups by means of radiologic, micro tomographic, biomechanical, and histological investigations. RESULTS: Compared to LS callus, VFLS(3) callus was 40% larger and about 3% denser, while VFLS(6) callus was 93% larger and its density about 7.2% lower. VFLS(3) showed 65% and VFLS(6) 163% larger amount of callus at the cis-cortex. There wasn’t a significant difference in the amount of callus at the cis and trans-cortex in groups featuring variable fixation only. Investigated biomechanical variables were not significantly different among groups and histology showed comparable good healing in all groups. Tissues adjacent to the implants did not show any alteration of the normal structure in all groups. CONCLUSIONS: Variable fixation promoted the formation of a larger amount of bone callus, equally distributed at the cis and trans cortices. The histological and biomechanical properties of the variable fixation callus were equivalent to those of the standard fixation callus. The magnitude of variable fixation had a biological effect on the formation of bone callus. At the implantation site, the usage of variable fixation did not raise additional concerns with respect to standard fixation. The formation of a larger amount of mature callus suggests that fractures treated with variable fixation might have a higher probability to bridge the fracture gap. The conditions where its usage can be most beneficial for patients needs to be clinically defined. BioMed Central 2020-12-03 /pmc/articles/PMC7713143/ /pubmed/33272239 http://dx.doi.org/10.1186/s12891-020-03781-6 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Plecko, Michael
Klein, Karina
Planzer, Katrin
Wähnert, Dirk
Behm, Pascal
Ferguson, Stephen J.
Brianza, Stefano
Stadelmann, Vincent A.
von Rechenberg, Brigitte
Variable fixation promotes callus formation: an experimental study on transverse tibial osteotomies stabilized with locking plates
title Variable fixation promotes callus formation: an experimental study on transverse tibial osteotomies stabilized with locking plates
title_full Variable fixation promotes callus formation: an experimental study on transverse tibial osteotomies stabilized with locking plates
title_fullStr Variable fixation promotes callus formation: an experimental study on transverse tibial osteotomies stabilized with locking plates
title_full_unstemmed Variable fixation promotes callus formation: an experimental study on transverse tibial osteotomies stabilized with locking plates
title_short Variable fixation promotes callus formation: an experimental study on transverse tibial osteotomies stabilized with locking plates
title_sort variable fixation promotes callus formation: an experimental study on transverse tibial osteotomies stabilized with locking plates
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7713143/
https://www.ncbi.nlm.nih.gov/pubmed/33272239
http://dx.doi.org/10.1186/s12891-020-03781-6
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