Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: General Orthopaedics
Abstract number: 26373
LCP FOR FIXATION OF FREE FIBULA GRAFT: IN VITRO BIOMECHANICAL
STUDY AND CLINICAL RESULTS
Andrey SEREDA, Andrey GRITSYUK
National Pirogov Medicine Center, Moscow (RUSSIA)
Treatment of forearm bone defects more than 5 cm long is a challenging problem. In
such cases the method of choice is vascularized fibula transfer. But the question is
how to fixate graft. We hypothesized that the LCP would be the best, because we
need 1) to fix fibula stable, 2) minimize blade pressure on bone surface (it is
particularly important in circumstances of free vascularised graft) and 3) to achieve
appropriate axial compression in two places between recipient bone and graft
(bilocal compression). In order to help justify the use of the LCP for fixation of free
fibula graft an In vitro biomechanical testing was performed. The 3.5 mm LCP were
applied over a osteotomied bone simulating bone defect and free fibula graft. Blade
pressure on bone surface with traditional and locking screws (bicortical and
unicortical), axial compression with bicortical and unicortical screws and bilocal
compression with bicortical and unicortical screws were studied. Mean blade
pressure on bone with traditional and locking screw was 40.1N and 1.1N
respectively, axial compession achieved 25.4N and biaxial 36.4N. So we suppose
that it is better to fix free fibula by unicortical locking screws and than bilocal
compression by traditional screws placed by the each side of the graft should be
done. 11 patients with ulna or radius were treated by this technique. At the end in all
cases defect was reconstructed successfully. In one case we have met fatigue plate
failure, reosteosyntesis was made using another LCP.
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