LagLoc—a new surgical technique for locking plate systems. Issue 11 (13th July 2018)

• Record Type: Journal Article
• Authors: Triana, Miguel; Gueorguiev, Boyko; Sommer, Christoph; Stoffel, Karl; Agarwal, Yash; Zderic, Ivan; Helfen, Tobias; Krieg, James C; Krause, Fabian; Knobe, Matthias; Richards, Robert Geoff; Lenz, Mark
• Is Part Of: Journal of orthopaedic research. Volume 36:Issue 11(2018)
• Page Start: 2886
• Page End: 2891
• Publication Date: 2018-07-13
• Subjects: lag screw -- locking screw -- interfragmentary compression -- locking plate; Orthopedics -- Periodicals; Musculoskeletal system -- Periodicals; 616.7
• DOI: 10.1002/jor.24069
• Languages: English
• ISSNs: 0736-0266

Abstract

ABSTRACT: Treatment of oblique and spiral fractures remains challenging. The aim of this study was to introduce and investigate the new LagLoc technique for locked plating with generation of interfragmentary compression, combining the advantages of lag screw and locking‐head‐screw techniques. Oblique fracture was simulated in artificial diaphyseal bones, assigned to three groups for plating with a seven‐hole locking compression plate. Group I was plated with three locking screws in holes one, four, and seven. The central screw crossed the fracture line. In group II the central hole was occupied with a lag screw perpendicular to fracture line, whereas holes one and seven were occupied with locking screws. Group III was instrumented applying the LagLoc technique as follows. Hole four was predrilled perpendicularly to the plate, followed by overdrilling of the near cortex and insertion of a locking screw—crossing the fracture line—whose head was covered by a holding sleeve to prevent temporarily the locking in the plate hole and generate interfragmentary compression. Subsequently, the screw head was released and locked in the plate hole. Holes one and seven were occupied with locking screws. Interfragmentary compression in the fracture gap was measured using pressure sensors. All screws in the three groups were tightened with 4 Nm torque. Interfragmentary compression in group I (167 ± 25 N) was significantly lower in comparison to groups II (431 ± 21 N) and III (379 ± 59 N), p ≤ 0.005. The difference in compression between groups II and III remained not significant ( p = 0.999). The new LagLoc technique offers an alternative tool to generate interfragmentary compression with the application of locking plates by combining the biomechanical advantages of lag screw and locking screw fixations. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2886–2891, 2018. Abstract : In an oblique fracture model we compared the interfragmentary compression achieved with conventional locked plating, locking plate fixation with use of a lag screw, and the new LagLoc fixation technique. The latter offers an alternative tool by combining the biomechanical advantages of lag screws and locking screw fixations. The interfragmentary compression with the new technique was comparable to the locking plate fixation with a lag screw, and both these techniques resulted in considerably higher compression versus the conventional locked plating.