Fracture Gap Research Articles (Page 1)

Associating maternal keel fracture severities with egg quality, hen reproductive outcome, and chick welfare.

How vascularization is reciprocally coupled to chondrogenesis and osteogenesis in bone healing: lessons from the growth plate.

Roles of a nonvascularized fibular graft with and without fixation in the treatment of segmental tibial bone loss: A finite element analysis.

Background/Objectives: Odontoid fractures—prevalently Anderson–D’Alonzo type II—are clinically relevant for their biomechanical instability and risk of non-union. Posterior C1–C2 fusion yields the highest fusion rates but sacrifices atlantoaxial rotation. Anterior odontoid screw fixation (AOSF) enables direct osteosynthesis while preserving motion. This study aimed to evaluate the radiographic outcomes, fusion rate, and technical considerations of AOSF in a consecutive single-center series, highlighting anatomical and procedural factors influencing bone healing. Methods: Retrospective, single-center case series of patients who underwent AOSF for acute type II odontoid fractures (2018–2024). Inclusion criteria included CT-confirmed fractures with reducible alignment. Radiographic parameters (fracture gap and angulation) were measured on standardized sagittal CT reconstructions. Outcomes were evaluated at 6 weeks, 3 months, and 6 months. Mean follow-up was 24 months. Results: The mean fracture gap decreased from 5.3 mm preoperatively to 0.8 mm postoperatively, and angulation from 27.8° to 3.5° (p < 0.0001). Nine of ten patients (90%) achieved solid fusion; one required secondary posterior fixation. No intra- or postoperative infections, neurovascular injuries, or neurological deficits were observed. Conclusions: AOSF is a safe and effective motion-preserving technique in appropriately selected Grauer IIA/IIB fractures. Precise anatomical reduction (<2 mm gap, <5–10° angulation) is a key predictor of successful fusion, even in elderly patients. Future multicenter studies with larger cohorts and standardized clinical outcome measures are needed to validate radiographic thresholds and optimize patient selection.

To identify clinical and radiographic findings of pediatric scaphoid fractures that predict the need for surgical treatment. A retrospective review of pediatric patients (≤ 18years) with scaphoid fractures, who underwent radiographic examination and treatment at our tertiary care pediatric hospital, between 2018 and 2024, identified all surgically treated patients. From the remaining conservatively treated patients, agematched comparisons were randomly selected. After randomization and blinded to outcome, skeletal age, fracture characteristics (location, displacement, comminution, articular involvement, perifracture radiodensity, lobulated perifracture resorption, fracture gap), and presence or absence of osteonecrosis were recorded. Findings were compared between surgically treated and conservatively treatd groups to identify predictors of surgery. Ninety-six children (81 males, 15 females, mean age: 15.0 ± 1.8years, range: 11.0-17.8) included 48 in the surgery and 48 in the non-surgery groups. Proximal pole fractures (8.3%, 8/96), perifracture radiodensity (26.0%, 25/96), and presence of osteonecrosis (12.5%, 12/96) were uncommon, but were only found among patients in the surgery group. Presence of displacement (81.3% vs. 12.2%, p < 0.01) and more severe displacement (2.2 vs. 0.7mm, p < 0.01), articular involvement (37.5% vs. 8.3%, p < 0.01), and lobulated perifracture resorption (64.6% vs. 10.4%, p < 0.01) were more common among patients in the surgery than patientsin the non-surgery groups. Logistic regression analyses found proximal pole fractures (OR = 6.67, 95% CI: 1.48-16.78, p = 0.04), fracture displacement (OR = 6.30, 95% CI: 1.32-33.87, p < 0.01), and longer delay to initial radiographs (OR = 1.08, 95% CI: 1.04-1.18, p = 0.01) were independent predictors of surgery. Children with scaphoid fractures are more likely to require surgery if radiographic evaluation is delayed, fracture is displaced, or involves the proximal pole.

Background and Objectives: Diffuse idiopathic skeletal hyperostosis (DISH)-related spinal fractures with marked anterior distraction are highly unstable and pose substantial surgical challenges. The transdiscal screw for diffuse idiopathic skeletal hyperostosis (TSD) technique has been proposed to enhance fixation strength by penetrating adjacent vertebral endplates; however, its clinical utility in large-displacement cases remained unclear. Materials and Methods: In this retrospective study, we reviewed 21 patients with thoracolumbar DISH-related fractures and an anterior fracture gap ≥ 15 mm, who underwent posterior fixation between 2010 and 2024. 11 patients underwent TSD fixation (TSD group), and 10 underwent conventional fixation without bilateral TSD (control group). Results: The mean number of fused segments did not differ significantly between the groups (5.0 ± 1.4 vs. 5.0 ± 1.3, p = 0.43). Operative time was comparable (164 ± 57 vs. 168 ± 60 min, p = 0.90). Blood loss tended to be lower in the TSD group (306 ± 334 vs. 528 ± 658 mL, p = 0.33). For fracture-gap reduction, the TSD group improved from 17.4 ± 2.3 mm preoperatively to 13.8 ± 4.4 mm postoperatively and 2.0 ± 3.6 mm at final follow-up, while the control group showed less reduction (16.8 ± 2.2, 15.4 ± 1.4, and 7.0 ± 9.1 mm, respectively). Screw loosening occurred in three TSD patients and six controls (p = 0.13). All patients in the TSD group achieved bone union without reoperation, whereas four controls experienced implant backout, three required reoperation, and two failed to achieve bone union (p = 0.035). Conclusions: Posterior fixation using TSD provided reliable stability, maintained reduction, and reduced the risk of implant failure compared with conventional fixation in highly unstable DISH-related fractures with anterior distraction. Although larger prospective studies are needed, TSD may represent a valuable surgical option for this challenging patient population.

Nonunion of a displaced patellar fracture results in an elongated, incompetent extensor mechanism. Surgical repair must address loss of mobility of the extensor mechanism tendon and muscular components, bone resorption, impaired fracture biology, a wide fracture gap, and distracting forces across the nonunion site. A novel patellar nonunion fixation technique for the treatment of chronic patella nonunion is described including medial parapatellar arthrotomy, anterior interval release, open lysis of intra-articular adhesions, lateral capsular release, modified quadricepsplasty, tension band plating, autograft bone harvested from the proximal tibia, and quadriceps tendon advancement. Five patients treated with this technique achieved both clinical and radiographic union within 3 months and a mean active knee flexion of 98 degrees (range 45-140 degrees) with independent ambulation and without complication at 1-year follow-up.

To determine whether a secondary plate on the caudolateral aspect of the scapula increases stiffness and reduces primary plate strain compared to a single plate along the cranial scapula spine in a comminuted fracture gap model. Ex vivo mechanical study. A total of 14 paired canine scapulae. A comminuted fracture gap model was created. A 2.4 mm plate was secured along the cranial aspect of the scapula spine in 28 scapulae. A secondary 2.0 mm plate was secured on the caudolateral border of 14 scapulae. Scapula were sinusoidally loaded from -20 to -200 N for 7200 cycles at 2 Hz. The displacement was measured, and stiffness calculated. Digital image correlation calculated primary plate surface strain. A two-way ANOVA assessed displacement and stiffness. Primary plate strain was assessed with a paired t-test. Statistical significance was set at p < .05. Mean displacement was higher in the single plate group, -0.81 mm (± 0.14) compared to the double plate group, -0.48 mm (± 0.08) (p < .0001). Mean stiffness was lower in the single plate group, 392.8 N/mm (± 13.72) compared to the double plate group, 563.7 N/mm (± 5.89) (p <.0001). There was no difference in primary plate surface strain between the two groups. Double plate fixation improved stiffness in a comminuted scapula fracture gap model compared to single plate fixation. The placement of an additional plate placed on the caudolateral aspect of the scapula improves stiffness in comminuted scapula body fractures.

Evaluation of PLA gyroid scaffold for long bone fracture treatment: numerical and experimental study.

Radiological and Clinical Outcomes of Monoaxial versus Polyaxial Screw Constructs in C1 Jefferson Fracture Osteosynthesis: A Retrospective Study.

Summary Squeeze cementing is one of the most common techniques used to remediate well integrity issues. Understanding the mechanisms controlling cement particle penetration and/or bridging as well as assessing the potential of cement blends in narrow gaps is important for the design of a successful squeeze cement job. The main objectives of this study are to determine the penetration potential of different cement blends, determine the critical gap width where bridging of cement particles starts, and compare the fracture conductivity of the sample before and after remediation. Four different cement systems were tested for their ability to penetrate and plug narrow fracture gaps, including American Petroleum Institute (API) Class G (A1, largest particles), Portland limestone-blended cement (A2, medium particles), microfine cement (A3, smallest particles), and semi-microfine API Class C (A4). Cylindrical cement plugs were cured at 6890 kPa and 50°C for 7 days and cut into halves to create replicas of fractured cement samples. Metal shims of 150 μm, 100 μm, and 50 μm in thickness were used to control the gap size. Cement microsqueeze jobs were conducted under a differential pressure of 2068 kPa (300 psi) using a conventional core flow setup. The fractured cement samples were imaged using microcomputed tomography (CT) scanning before and after remediation to determine both the fracture width and the slurry flow pathway. Results showed that A2, A3, and A4 cement were able to fully penetrate and seal fractures ≥70–80 μm, whereas A1 experienced bridging and nonuniform penetration. For narrower gaps (around 40 μm), none of the tested cement blends achieved complete penetration. A reduction (varying between three and six orders of magnitude) of the fracture conductivity was observed after squeeze cementing, even though the cement did not fully penetrate the fractured cement samples in some cases. Squeeze cement slurry progression in the fracture takes place in several modes, all controlled mainly by the narrowest gap width size (GW)/particle size (PS) ratio. At a high GW/PS ratio, the cement slurry was distributed uniformly. At a moderate GW/PS ratio, bridging and partial plugging of the fractures were observed, leading to slurry flow in a fingered pattern. At low GW/PS ratio, only filtrate flow was observed. Comparison of the results from all 13 cases of squeeze cementing experiments conducted throughout this study suggests that there may be a critical GW/PS (D90) ratio, which controls the particle bridging vs. flow (and the depth of cement slurry penetration into the fracture), and this number is somewhere between 2.2 and 2.4. When the minimum fracture GW/PS (D90) ratio is around 2.2 or lower, cement slurry starts to bridge, thus preventing further filling of the gap by the squeezed cement. When the minimum fracture GW/PS (D90) ratio is sufficiently higher than 2.2, cement bridging does not occur, and the cement slurry completely fills the fracture. When the minimum fracture GW/PS (D90) ratio is much less than 2, the cement slurry flow stops suddenly in the narrowest region without any fingering and filtration. Preliminary results from this study suggest that remedial cementing penetration strongly correlates with fracture gap size/cement particle size (D90) ratio. However, more data, like those presented in this study, are needed before we can suggest a more accurate value of critical GW/PS ratio, which controls the probability of plugging in any squeeze job.

BackgroundThe locking compression plate extra-articular distal humeral plate (EADHP) is an anatomically pre-contoured plate that is used for extra-articular distal humeral fractures. However, there is currently no standard criterion for the internal fixation of this type of fracture. Moreover, the anterior reverse proximal humeral internal locking system (PHILOS) plate (ARPP) has been clinically applied as a new internal-fixation plate without testing in biomechanical studies. We aimed to compare the biomechanical properties of ARPP and EADHP for the definitive fixation of extra-articular distal humeral fractures.MethodsEighteen composite humerus bones were cut at the distal humerus using an electrical saw to generate a fracture gap. Internal fixation via the ARPP or EADHP was performed following standard techniques. An Instron testing machine (Instron 8872) was used to evaluate biomechanical properties by applying bending torque, axial force, and torsional torque.ResultsFixations with both ARPP and EADHP could withstand forces that exceeded the physiological forces (200 N). Under axial compression, ARPP constructs demonstrated greater stiffness (668.9 ± 120.7 N/mm vs 171.2 ± 45.4 N/mm) and higher maximal load-to-failure (2,092.6 ± 305.2 N vs 907.0 ± 56.5 N) compared with EADHP, although these differences were not statistically significant. During anterior bending, ARPP provided significantly higher stiffness (17.8 ± 2.0 N/mm vs 13.9 ± 1.0 N/mm, p = 0.041), whereas EADHP showed a higher but non-significant load-to-failure. Under torsional loading, ARPP tended to exhibit greater stiffness in both external and internal rotation, as well as higher load-to-failure (31.1 ± 0.8 N m vs 26.0 ± 4.4 N m), but without statistical significance.ConclusionARPP demonstrated superior bending stiffness compared with the EADHP, while both constructs performed equivalently in axial compression and torsion. Therefore, ARPP can serve as an alternative internal-fixation method for extra-articular distal humeral fractures.

Bone healing occurs through two distinct pathways: direct (primary) and endochondral ossification, with the mechanical environment at the fracture site being crucial in determining the respective pathway. Absolute stability promotes direct (primary or Haversian) bone healing via the migration and direct osteogenic differentiation of mesenchymal stromal cells across the fracture line. On the other hand, it is widely accepted that secondary fracture healing is triggered by a certain level of mechanical stimulation that initiates and promotes a cascade of events towards the formation of an intermediate cartilaginous callus matrix, that will eventually remodel into bone.In his strain theory, back in 1980, Prof Perren proposed that the bone healing process is regulated by the displacement applied at the fracture site relative to the size of a fracture gap (strain). Since, many in vivo studies have further investigated the affect of mechanical stimulus on the bone healing outcome, by applying different regiments or loading types. Though, optimal stimulation parameters to enhance fracture healing have not yet been entirely defined. There are still uncertainties concerning the magnitude of the deformation, its frequency, timing and duration. In addition, the influence of those parameters on the cellular process of hypertrophic cartilage formation and remodeling - critical for bone healing - is still not fully understood. In this context, our latest research focused on understanding the influence of mechanical parameters on the differentiation fate of naïve mesenchymal stem cells, using a custom-designed bioreactor for precise manipulation of strain conditions and loading protocols.A better understanding of the effect of strain on the cellular response and mechanism involved during hypertrophic chondrocyte differentiation and callus formation is crucial knowledge for the development of biomechanically optimized implants, as well as for the establishment of superior rehabilitation protocols.

PurposeThe prescribed amount of weight-bearing after tibial plateau fractures is controversial because it affects osteosynthetic construct stability and fracture healing. We aim to introduce a simulation model that adequately predicts the effects of different weight-bearing amounts on stability and healing, based on the patient’s individual fracture pattern and treatment construct.MethodsTo safely test different amounts of weight-bearing limits, we first extracted knee joint forces for different weight-bearing limits from musculoskeletal simulation based on monitoring data of 22 uninjured participants. Correct loading was ensured with a force-measuring insole. We then tested three patients after tibial plateau fracture with their current weight-bearing level and constructed a simulation model determining implant stress, knee joint force, and fracture gap interfragmentary strain. The patient-specific weight-bearing level was then substituted for weight-normalized uninjured participant data to test different weight-bearing levels in the simulation model.ResultsThe simulation model calculated individual construct stiffness and interfragmentary strain at different weight-bearing levels following the clinical course. When comparing the patient’s individual weight-bearing input with the weight-normalized input of the uninjured participants at the same level, comparable knee joint forces were extracted, showing the feasibility of this approach.ConclusionUsing an adapted reference movement database, the model allows the determination of safe weight-bearing ranges concerning construct stability and fracture healing based on individual fracture morphology and treatment without exposing patients to excessive weight-bearing. Future studies can test this approach in more extensive patient-number studies and different treatment situations.

The aim of the study was to design a standardized mechanical test setup and a corresponding finite element analysis to assess the stability and strength of both patient-specific and conventional implants for posterior wall acetabular fractures. Ten synthetic hemi-pelves with posterior wall fractures were biomechanically tested with two types of implants: a patient-specific implant (PSI) and a seven-hole plate conventional implant. 3D-printed guides ensured reproducibility. The models were tested using an Instron machine. The protocol involved 10,000 cyclic load cycles with static tests at 3200 N before and after to simulate early postoperative weightbearing conditions. Construct stiffness, stiffness over cyclic loading and fracture gapping were measured and compared. A finite element analysis was created with similar conditions to investigate stresses within the synthetic bone and fixation materials. The mechanical tests showed comparable stiffness for PSI (1.75 kN/mm) and the conventional implant (1.71 kN/mm, p = 0.47). Stability over 10,000 cycles was similar, and fracture gapping remained minimal (0.0-0.8 mm) without significant differences. No failure or plastic deformation occurred under 3200 N loading. Finite element analysis confirmed that von Mises stresses remained below the yield stress. This study introduces a reproducible workflow for biomechanical testing of acetabular fractures using synthetic bone models and 3D-printed guides. It serves as a step-by-step guideline and standard reference for pelvic biomechanical testing. Both patient-specific and conventional implants, using a seven-hole plate construct with one or two screws through the plate in the fracture fragment, provide stable fixation for large posterior wall fragments.

Background/Objectives: The combined effect of femoral neck–shaft angle and lag screw position on unstable intertrochanteric fracture fixation has not been well established. This biomechanical study evaluated the effects of two caput–collum–diaphyseal (CCD) angles and two lag screw positions on construct stability. Methods: Twenty-four synthetic femurs with identical AO/OTA 31-A2.2 fracture gaps (2 mm) were fixed using cephalomedullary nails with CCD angles of either 125° or 130°, each with a central or inferior (calcar) lag screw (n = 6/group). Constructs were tested in a single-leg stance under preloading, cyclic loading (75–750 N, 10,000 cycles, and 2 Hz), and axial loading to failure. Lag screw migration was measured radiographically, and femoral head rotation was recorded using a three-dimensional coordinate-measuring device. Stiffness, failure load, and rotations were compared using the Kruskal–Wallis and Bonferroni post hoc tests. Results: The 125° inferior configuration showed the highest stiffness (188 ± 15 N/mm, p = 0.038) and failure load (1350 ± 97 N, p = 0.047), with the least screw migration (0.54 ± 0.11 mm, p = 0.003), significantly outperforming the 125° central and 130° central constructs. However, it exhibited greater varus collapse (2.25 ± 0.27°, p = 0.013) and axial rotation (~20–30% higher than others, p = 0.025). Screw position had a stronger effect on stability than the CCD angle, although the 130° inferior construct showed slightly less varus deformation. Conclusions: An inferior calcar-guided lag screw improves fixation strength and stiffness in unstable intertrochanteric fractures, particularly in those with a 125° nail. However, this configuration increases varus and rotational displacement, warranting adjunct measures to enhance rotational control in clinical applications.

To describe and compare arthroscopy-assisted (AA) with fluoroscopy-assisted (FA) minimally invasive plate osteosynthesis (MIPO) for simple transverse acetabular fractures. Ex vivo cadaveric study. A total of 10 canine cadavers (>20 kg) without coxofemoral joint disease. Pelvic computed tomography (CT) images were mirrored and three-dimensional (3D) printed to create models for precontouring 2.7-mm locking compression plates (LCP). Acetabula were randomly assigned to AA or FA MIPO groups and pelvis were prepared for stabilization by standardized osteotomies of the pubic, ischial and acetabular bones. In the AA group, fracture reduction was arthroscopically confirmed, and precontoured plates were applied via small approaches to the ilium and ischium. In the FA group, reduction was guided fluoroscopically. Surgical time, incision length, procedural complications, and feasibility were recorded. Postprocedural CT scans measured fracture gap, step formation, medio-lateral displacement and pelvic angulation. Necropsy assessed iatrogenic injuries. MIPO was successful for all 20 acetabula. Mean procedure time and incision length were not significantly different between groups. Mean fracture gaps and step defects were <1 mm in both groups. Medio-lateral displacement exceeded 1 mm in the FA group (median 1.08 mm) compared to 0.74 mm in the AA group. Low coronal angles (<5°) were consistent across procedures. Sciatic nerve injury occurred in one case per group. Minor superficial cartilage damage was common. Arthroscopy-assisted MIPO was feasible for simple acetabular fractures, resulting in anatomic (6/10) or near-anatomic (4/10) reductions. Further studies and clinical experience are necessary before recommending AA as an alternative for open approaches.

Comparative clinical efficacy of nickel-titanium shape memory staples versus miniplate for Bartoníček-Rammelt type III and IV posterior malleolar fractures. A retrospective analysis of 47 consecutive patients treated between January 2022 and June 2024 documented operative time, intraoperative blood loss, fluoroscopy times, healing time, complications, postoperative fracture gap distance (mm), and articular surface step-off (mm) at the ankle joint. Ankle function was assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, the Manchester-Oxford Foot Questionnaire (MOXFQ), and range of motion measurements at 3, 6, 12, and 14 months. There were no statistically significant differences in baseline characteristics between the 2 groups. The shape-memory alloy group exhibited significantly shorter operative time [65.0 (60.0, 70.0)], less intraoperative blood loss [40.0 (30.0, 50.0)], and fewer intraoperative fluoroscopy instances [5.0 (4.0, 6.0)] than the miniplate group, with all differences showing statistical significance (P < .05). Postoperative imaging examinations revealed no significant differences in the fracture gap distance and articular surface step height of the ankle joint between the 2 groups. At 3 months, 6 months, and the final follow-up, there were no statistically significant differences in the AOFAS ankle-hindfoot scores and MOXFQ scores between the 2 groups of patients (P > .05). At the final follow-up, the AOFAS ankle-hindfoot scores and MOXFQ scores of all patients showed statistically significant differences compared to those at 3 and 6 months postoperatively (P < .05). At the final follow-up, there were no statistically significant differences in the range of motion for ankle dorsiflexion, plantarflexion, inversion, or eversion between the 2 patient groups (P > .05). Both nickel-titanium shape memory staples and miniplates achieved good clinical outcomes in the treatment of Bartoníček-Rammelt type III and IV posterior malleolar fractures. Both methods maintained satisfactory fracture reduction and resulted in favorable functional recovery of the ankle joint. However, the nickel-titanium shape memory staples offered advantages in shorter operative time, reduced intraoperative blood loss, and fewer intraoperative fluoroscopy exposures.

ObjectiveAnterior odontoid screw fixation (AOSF) has several advantages over posterior C1–2 fusion for Grauer type II and shallow type III odontoid fractures. However, the risk factors for fusion failure, particularly in terms of 3-dimensional (3D) measurements, remain unclear. This study investigated the impact of fracture deficit volume (FDV), a novel 3D measurement, on fusion outcomes in patients undergoing AOSF.MethodsWe enrolled 44 patients with Grauer type II or shallow type III odontoid fractures treated with AOSF at a single institution. Radiological assessments included preoperative and postoperative measurements of the fracture gap and fracture displacement on computed tomography (CT) scans. FDV was calculated through 3D CT reconstruction of preoperative and immediate postoperative CT to quantify the spatial gap between the edges of the fractures. Fusion outcomes were defined as solid union, fibrous union, or nonunion. Logistic regression and a generalized additive model (GAM) were used to identify risk factors for fusion failure after AOSF.ResultsSolid fusion was achieved in 77.3% of patients. A reduction in the FDV with respect to the preoperative value was significantly associated with successful fusion (p=0.028), whereas patients presenting an increased FDV postoperatively were more likely to exhibit fusion failure (p=0.006). Age≥65 years, a fracture gap≥2 mm, and an increased FDV postoperatively were significant risk factors for fusion failure. GAM analysis revealed a linear relationship between a reduced FDV and improved fusion rates (adjusted R2=0.186, p=0.018).ConclusionThe risk of fusion failure is greater in elderly patients, those with a fracture gap greater than 2 mm, and those with an increased FDV postoperatively. Among the modifiable risk factors, FDV had the greatest impact on fusion outcomes after AOSF.

IntroductionThe conventional pin and tension band wiring (TBW) technique remains the standard for fixation, but is frequently associated with complications such as wire breakage, loosening, and delayed healing in patellar fracture. Locking plate fixation has demonstrated superior biomechanical stability in human studies. This study aimed to compare the biomechanical performance of locking plate fixation versus TBW in canine transverse patellar fractures and to evaluate the influence of plate design on fixation strength.MethodsThirty 3D-printed canine patellar fracture models were fabricated based on CT data from a 45 kg Akita dog and allocated into three groups (n = 10 per group): Group 1—pin/TBW fixation, Group 2—2-hole locking plate fixation, Group 3—4-hole locking plate fixation. All models were subjected to tensile testing at a 135° stifle angle to simulate quadriceps force. Fixation failure was defined as a fracture gap displacement greater than 2 mm or structural yielding.ResultsGroup 1 showed progressive displacement with increasing tensile load (1 mm: 226.4 ± 26.2 N; 2 mm: 280.8 ± 27.7 N; 3 mm: 342.7 ± 27.0 N). Groups 2 and 3 exhibited less than 1 mm displacement and significantly higher maximum failure loads (Group 2: 505.6 ± 66.6 N; Group 3: 556.9 ± 39.6 N; p < 0.05). No significant difference was observed between the 2-hole and 4-hole plate groups.DiscussionLocking plate fixation demonstrated significantly superior biomechanical stability compared to the traditional pin/TBW technique in a canine transverse patellar fracture model. The comparable performance of the smaller 2-hole locking plate suggests its potential utility in clinical applications, particularly for small-breed dogs. These findings support the clinical applicability of locking plate systems as a reliable alternative for patellar fracture stabilization in veterinary practice.