{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T04:25:16Z","timestamp":1742963116917,"version":"3.40.3"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wrist Surg"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Volar-locked plating has become a popular treatment option for unstable distal radius fractures. While using locking screws in the distal fragment increases the stability of the fixation, the biomechanical benefits of locking fixation in the proximal fragment have not been definitively established.<\/jats:p><jats:p>\n          Purposes\u2003This study evaluated the initial mechanical behavior of the volar plating construct with different locking screw configurations in the proximal fragment.<\/jats:p><jats:p>\n          Materials and Methods\u2003Sixteen Sawbones radius models were used. An unstable metaphyseal distal radius fracture was created and fixated with a volar-locked plate. Four different screw configurations in the proximal fragment were tested: all nonlocking screws, locking screw in the distal-most hole, locking screw in the proximal-most hole, and locking screws in both the proximal- and distal-most holes. Initial stiffness, displacement during harmonic loading, and load-to-failure were compared among the three groups.<\/jats:p><jats:p>\n          Results\u2003The initial stiffness, displacement during harmonic loading, and load-to-failure did not significantly differ among the four proximal screw configurations (p\u2009&lt;\u20090.05). Failure occurred via toggling of the screws in the configuration with all nonlocking screws and through screw breakage or locking mechanism failure in the configurations with locking screws.<\/jats:p><jats:p>\n          Conclusion\u2003The use of locking screws in the proximal fragment did not significantly affect the initial stability of volar distal radius plating. However, failure modes differed between the nonlocking and locking configurations, consistent with known mechanical properties of locking fixation. Further mechanical studies in cadaveric models and clinical trials are warranted to determine the optimal screw configuration in volar distal radius plating.<\/jats:p><jats:p>\n          Level of Evidence\u2003To be determined. Biomechanical study on synthetic models.<\/jats:p>","DOI":"10.1055\/s-0044-1779342","type":"journal-article","created":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T23:55:33Z","timestamp":1706745333000},"page":"151-157","source":"Crossref","is-referenced-by-count":0,"title":["The Role of Proximal Locking Fixation in Volar Distal Radius Fracture Fixation"],"prefix":"10.1055","volume":"14","author":[{"given":"Leland","family":"Gossett","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Rochester School of Medicine and Dentistry, Rochester, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giap H.","family":"Vu","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, University of Rochester School of Medicine and Dentistry, Rochester, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wayne","family":"Reizner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Rochester School of Medicine and Dentistry, Rochester, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Gira","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, University of Rochester School of Medicine and Dentistry, Rochester, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bowen","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Rochester School of Medicine and Dentistry, Rochester, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hani A.","family":"Awad","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Rochester School of Medicine and Dentistry, Rochester, New York"},{"name":"Department of Biomedical Engineering, University of Rochester School of Medicine and Dentistry, Rochester, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constantinos","family":"Ketonis","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Rochester School of Medicine and Dentistry, Rochester, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,1,31]]},"reference":[{"issue":"12","key":"ref1","doi-asserted-by":"crossref","first-page":"2687","DOI":"10.2106\/00004623-200612000-00016","article-title":"Treatment of unstable distal radial fractures with the volar locking plating system","volume":"88","author":"K C Chung","year":"2006","journal-title":"J Bone Joint Surg Am"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"28","DOI":"10.5435\/00124635-200501000-00005","article-title":"Volar fixed-angle plating of the distal 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Orbay","year":"2004","journal-title":"J Hand Surg Am"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1186\/1471-2474-15-250","article-title":"Quality of life after volar locked plating: a 10-year follow-up study of patients with intra-articular distal radius fractures","volume":"15","author":"P Ruckenstuhl","year":"2014","journal-title":"BMC Musculoskelet Disord"},{"issue":"445","key":"ref7","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1097\/01.blo.0000205891.96575.0f","article-title":"Current concepts in volar fixed-angle fixation of unstable distal radius fractures","volume":"445","author":"J L Orbay","year":"2006","journal-title":"Clin Orthop Relat Res"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.jhsa.2005.10.010","article-title":"Functional outcome and complications after volar plating for dorsally displaced, unstable fractures of the distal radius","volume":"31","author":"T D 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Trauma"},{"issue":"06","key":"ref12","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1016\/j.jhsa.2010.03.027","article-title":"Number and locations of screw fixation for volar fixed-angle plating of distal radius fractures: biomechanical study","volume":"35","author":"I Mehling","year":"2010","journal-title":"J Hand Surg Am"},{"issue":"11","key":"ref13","doi-asserted-by":"crossref","first-page":"2411","DOI":"10.2106\/JBJS.E.00946","article-title":"Internal fixation of dorsally displaced fractures of the distal part of the radius. A biomechanical analysis of volar plate fracture stability","volume":"88","author":"A A Willis","year":"2006","journal-title":"J Bone Joint Surg Am"},{"issue":"08","key":"ref14","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1016\/j.injury.2016.04.005","article-title":"Is there a benefit of proximal locking screws in osteoporotic distal radius fractures? - A biomechanical study","volume":"47","author":"B Bockmann","year":"2016","journal-title":"Injury"},{"issue":"10","key":"ref15","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1097\/BOT.0b013e31818df8cb","article-title":"Are locking screws advantageous with plate fixation of humeral shaft fractures? A biomechanical analysis of synthetic and cadaveric bone","volume":"22","author":"R V O'Toole","year":"2008","journal-title":"J Orthop Trauma"},{"issue":"08","key":"ref16","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1097\/00005131-200409000-00003","article-title":"Biomechanics of locked plates and screws","volume":"18","author":"K A Egol","year":"2004","journal-title":"J Orthop Trauma"},{"issue":"06","key":"ref17","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1302\/2046-3758.16.2000078","article-title":"Fracture fixation with two locking screws versus three non-locking screws: a biomechanical comparison in a normal and an osteoporotic bone model","volume":"1","author":"B Grawe","year":"2012","journal-title":"Bone Joint Res"}],"container-title":["Journal of Wrist Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0044-1779342.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T02:25:50Z","timestamp":1742955950000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0044-1779342"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,31]]},"references-count":17,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2025,3,25]]},"published-print":{"date-parts":[[2025,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0044-1779342","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2163-3916","2163-3924"],"issn-type":[{"type":"print","value":"2163-3916"},{"type":"electronic","value":"2163-3924"}],"subject":[],"published":{"date-parts":[[2024,1,31]]}}}