A comparison between a hinged plate and screw system and a conventional tension-band plate and screw system used for correction of an angular deformity of the lower limb: an animal study

Zhenkai Wu, Dahang Zhao, Li Zhao, Jianlin Liu, Hai Li, Jie Zhu, Fengcang Ma, Daniel Edward Porter, Zhenkai Wu, Dahang Zhao, Li Zhao, Jianlin Liu, Hai Li, Jie Zhu, Fengcang Ma, Daniel Edward Porter

Abstract

Background: The purpose of the animal study is to introduce a newly designed hinged plate and screw system for correction of angular deformities of the lower limbs. The technique was compared with the use of a conventional tension-band plate and screw system.

Methods: This is a randomized controlled animal trial. Eight 3-month-old Bama miniature pigs were used to establish animal models. In each animal, one leg was randomly allocated into study group and another leg into control group. Legs of the study group were corrected with a hinged plate and screw system, and legs of the control group were corrected with a conventional tension-band plate and screw system. The corrective rates of medial slope angle, medial proximal tibial angle, and angle of the two arms of the hinged plate were measured. Residual stress on the implants was also evaluated. A P < 0.05 was statistical significant.

Results: At the final measurements of 18 weeks, the mean corrective rates of medial slope angle, medial proximal tibial angle, and angle of the two arms of the study group were 0.71°/week, 0.85°/week, and 2.18°/week, respectively; the data in the control group were 0.84°/week, 0.89°/week, and 2.13°/week, respectively. No significant difference was found between the groups regarding the mean corrective rates of the angles (P < 0.05). The mean residual stress in the study group was 643.35 MPa, and measurement in the control group was 1,273.63 MPa, with a significant difference (P < 0.05).

Conclusions: Compared to the conventional tension-band plate and screw system, the hinged plate and screw system may be more reliable for correction of angular deformities of the lower limb.

Figures

Figure 1
Figure 1
The newly designed hinged plate and screw system. (A) The plate has a hinge and two arms and two 2 mm diameter screws. (B) Maximal angle of the two arms. (C) Minimal angle of the two arms.
Figure 2
Figure 2
Sketch map of hemiepiphysiodesis. (A) The hinged plate almost completely matches the contour of the bone. (B) The straight conventional plate does not match the bone surface.
Figure 3
Figure 3
Intraoperative photos. (A) A hinged plate and screw system is implanted. (B) No obvious prominence observed after wound closure.
Figure 4
Figure 4
Measurements on standard anterioposterior radiograph of the knee joint. MSA, medial slope angle; MPTA, medial proximal tibial angle; and ATA, angle of the two arms.
Figure 5
Figure 5
Standard anterioposterior radiographs of the tibia. (A) Immediately after correction with a hinged plate and screw system. (B) Eighteen weeks after operation. (C) Immediately after correction with a conventional plate and screw system. (D) Eighteen weeks after operation.
Figure 6
Figure 6
Images of histological sections. The bluish green area shows periosteal and perichondral (Safranin-O/fast green stain; ×40). (A) A section obtained from the tibia of a 3-month-old Bama miniature pig. The pig used for comparison did not have an operation. (B) The periosteal and perichondral beneath the hinged plate are intact after 18 weeks. (C) The periosteal and perichondral beneath the conventional tension-band plate are almost vanished after 18 weeks.

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