Kim T, Ayturk UM, Haskell A, Miclau T, Puttlitz CM., J Foot Ankle Surg. 46(1):2-6., 2007 Jan 01
AbstractThe increased use of locking plates to treat difficult fracture scenarios has been advocated in patients that have reduced bone mineral density. One of these difficult fracture patterns, fixation of the distal fragment of a distal fibula fracture, may depend on unicortical and cancellous bony purchase.
This study investigated the construct stiffness afforded by using locking and conventional plating schema in a cadaveric model. Overall, the data indicate that a locking plate construct with two distal unicortical screws was mechanically equivalent to standard plating with 3 distal screws. In addition, fixation with the standard plates was dependent on bone mineral density (BMD) whereas the locking plate fixation was independent of BMD.
The clinical implication of this study is that locking plates may be advantageous in patients with the most severe osteoporosis.