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Does Provisional Minifragment Fixation Prevent Compression With Dynamic Compression Plating? A Biomechanical

Benjamin M Wheatley1, Patrick J Schimoler1,2, Eric C Hempen1

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|May 3, 2021
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Provisional fixation with a 2.0-mm minifragment plate does not affect the compressive force of a 3.5-mm compression plate during orthopedic surgery. This suggests minifragment plates can remain in place during definitive fixation.

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Area of Science:

  • Orthopedic surgery
  • Biomechanical engineering

Background:

  • Compression plating is a standard orthopedic technique.
  • Provisional fixation may influence the stability and force applied during definitive fixation.

Purpose of the Study:

  • To compare the compressive force generated by a 3.5-mm compression plate with and without prior fixation using a 2.0-mm minifragment plate.

Main Methods:

  • Composite humeral sawbones were transected and divided into two groups.
  • One group received a 3.5-mm compression plate fixation.
  • The second group received 2.0-mm minifragment plate provisional fixation followed by 3.5-mm plate fixation.
  • Compressive force was measured using a load cell after screw insertion.

Main Results:

  • No significant difference in force was observed after each compression screw insertion between the groups.
  • No significant difference in total compression was found when preload was considered.
  • P values for successive screws were 0.59 and 0.58, and for total compression was 0.93.

Conclusions:

  • Provisional minifragment fixation does not adversely affect compression plating forces.
  • Minifragment plates can remain in situ before definitive fixation, potentially simplifying surgical procedures.