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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Osteosynthesis of the clavicle after osteotomy in brachial plexus surgery: A biomechanical cadaver study

1
Department of Orthopedics and Traumatology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
2
Department of Pediatric Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
3
Department of Rehabilitation, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
4
Department of Neurosurgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
5
Institute of Anatomy, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
*
Author to whom correspondence should be addressed.
Medicina 2015, 51(2), 112-116; https://doi.org/10.1016/j.medici.2015.02.004
Received: 15 May 2014 / Accepted: 19 February 2015 / Published: 25 March 2015
Objective: The aim of this study was to evaluate and compare the biomechanical effects of locking plate superior and anteroinferior positioning on the osteosynthesis of the clavicles osteotomized obliquely.
Materials and methods: Ten matched pairs of fresh cadaveric clavicles osteotomized through the mid-shaft obliquely were repaired with a titanium 7-hole 3.5-mm reconstruction locking plate in the superior or the anteroinferior position. The maximal failure loads and the displacement of the specimens at 166 N, 183 N, 203 N loads were recorded by the machine in 3-point cantilever bending. Bending failure stiffness was calculated between 10–150 N and 151 N to maximal bending failure loads.
Results: The mean maximal failure load was 396.2 N (SD, 117.3) for superior constructs and 220.1 N (SD, 51.1) for anteroinferior one (P < 0.05). There was significant difference in displacement between superior and anteroinferior plated specimens at 183 N (6.3 [SD, 2] vs. 9.9 [SD, 3.6]) and 203 N (6.4 [SD, 0.6] vs. 11.7 [SD, 6.6]) loads; P < 0.05). Mean bending failure stiffness between 151 N and maximal loads was 22.6 N/mm (SD, 13.2) for superior plates and 11 N/mm (SD, 9) for anteroinferior plated clavicles (P < 0.05).
Conclusions: The superior plating of obliquely osteotomized clavicles with the titanium 7-hole 3.5-mm locking reconstruction plate had a significantly greater biomechanical stability at fixed loads of 183 N and 203 N than the anteroinferior plating in the inferior directed cantilever bending. The superior plating osteosynthesis exhibited a significantly greater stiffness from 151 N to maximal bending failure loads as well.
Keywords: Osteotomy; Osteosynthesis; Clavicle; Brachial plexus; Biomechanics Osteotomy; Osteosynthesis; Clavicle; Brachial plexus; Biomechanics
MDPI and ACS Style

Kontautas, E.; Gerulis, V.; Varžaitytė, L.; Vytautas Ambrozaitis, K.; Burkauskienė, A. Osteosynthesis of the clavicle after osteotomy in brachial plexus surgery: A biomechanical cadaver study. Medicina 2015, 51, 112-116.

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