Level of Sagittal Plane Fit of Plates on the Radial Shaft: A Cadaveric Study Comparing Precontoured and Straight Titanium Plates.

Abstract

During radial shaft fracture fixation, it is important to contour the plate appropriately to restore the radial bow in order to maintain normal forearm mechanics and motion. The aim of this study was to investigate the fit of precontoured radial shaft plates versus surgeon-contoured plates. Six 10-hole Acumed® precontoured volar and dorsolateral radius plates and twelve 10-hole Synthes straight titanium 3.5 mm LC-DCP plates were drilled with arrays of 1.5 mm diameter holes to permit measurement of the plate distance off bone. Plates were applied to 6 cadaver radii and secured with a screw on each end. Three plate conditions were tested: precontoured plates, precontoured plates with further surgeon contouring, and straight plates with surgeon contouring. Surgeon contouring time for each plate was recorded. Each plate was divided into 3 equal regions, and the average distance gaps for each region and the entire plate were calculated. For the volar side, precontoured plates had a larger total gap compared to that plate with additional surgeon contouring (1.4 mm difference) and the straight surgeon-contoured plates (1.2 mm difference). On the dorsal side, there was no difference in fit between the 3 plate conditions at any location. No differences were found in plate contouring times. The precontoured dorsal plate fit was as good as the surgeon-contoured plates indicating this plate could potentially be used in fracture surgery without further bending. The precontoured volar plate was under-contoured, on average, and would likely require further bending to restore the radial bow.