{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:33:54Z","timestamp":1787020434709,"version":"build-2736575974"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T00:00:00Z","timestamp":1622764800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T00:00:00Z","timestamp":1622764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100001473","name":"AO North America","doi-asserted-by":"crossref","award":["Fellowship Grant"],"award-info":[{"award-number":["Fellowship Grant"]}],"id":[{"id":"10.13039\/100001473","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Musculoskelet Disord"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nonunion following treatment of supracondylar femur fractures with lateral locked plates (LLP) has been reported to be as high as 21\u2009%. Implant related and surgeon-controlled variables have been postulated to contribute to nonunion by modulating fracture-fixation construct stiffness. The purpose of this study is to evaluate the effect of surgeon-controlled factors on stiffness when treating supracondylar femur fractures with LLPs:<\/jats:p>\n                    <jats:p>\n                      <jats:list list-type=\"order\">\n                        <jats:list-item>\n                          <jats:p>Does plate length affect construct stiffness given the same plate material, fracture working length and type of screws?<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Does screw type (bicortical locking versus bicortical nonlocking or unicortical locking) and number of screws affect construct stiffness given the same material, fracture working length, and plate length?<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Does fracture working length affect construct stiffness given the same plate material, length and type of screws?<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Does plate material (titanium versus stainless steel) affect construct stiffness given the same fracture working length, plate length, type and number of screws?<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Mechanical study of simulated supracondylar femur fractures treated with LLPs of varying lengths, screw types, fractureworking lenghts, and plate\/screw material. Overall construct stiffness was evaluated using an Instron hydraulic testing apparatus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Stiffness was 15\u2009% higher comparing 13-hole to the 5-hole plates (995\u00a0N\/mm849N vs. \/mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). The use of bicortical nonlocking screws decreased overall construct stiffness by 18\u2009% compared to bicortical locking screws (808\u00a0N\/mm vs. 995\u00a0N\/mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0001). The type of screw (unicortical locking vs. bicortical locking) and the number of screws in the diaphysis (3 vs. 10) did not appear to significantly influence construct stiffness (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.76,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.24). Similarly, fracture working length (5.4\u00a0cm vs. 9.4\u00a0cm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.24), and implant type (titanium vs. stainless steel,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.12) did also not appear to effect stiffness.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Using shorter plates and using bicortical nonlocking screws (vs. bicortical locking screws) reduced overall construct stiffness. Using more screws, using unicortical locking screws, increasing fracture working length and varying plate material (titanium vs. stainless steel) does not appear to significantly alter construct stiffness. Surgeons can adjust plate length and screw types to affect overall fracture-fixation construct stiffness; however, the optimal stiffness to promote healing remains unknown.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12891-021-04341-2","type":"journal-article","created":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T05:03:13Z","timestamp":1622782993000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["The effect of surgeon-controlled variables on construct stiffness in lateral locked plating of distal femoral fractures"],"prefix":"10.1186","volume":"22","author":[{"given":"Michael J.","family":"Weaver","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George W.","family":"Chaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aidin","family":"Masoudi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaveh","family":"Momenzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amin","family":"Mohamadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward K","family":"Rodriguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark S.","family":"Vrahas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ara","family":"Nazarian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,4]]},"reference":[{"key":"4341_CR1","doi-asserted-by":"publisher","unstructured":"Zlowodzki M, Bhandari M, Marek DJ, Cole PA, Kregor PJ. Operative treatment of acute distal femur fractures: systematic review of 2 comparative studies and 45 case series (1989 to 2005). J Orthop Trauma. 2006;20(5):366\u201371. doi:https:\/\/doi.org\/10.1097\/00005131-200605000-00013. PubMed PMID: 16766943. Epub 2006\/06\/13.","DOI":"10.1097\/00005131-200605000-00013"},{"key":"4341_CR2","doi-asserted-by":"publisher","unstructured":"Meek RM, Norwood T, Smith R, Brenkel IJ, Howie CR. The risk of peri-prosthetic fracture after primary and revision total hip and knee replacement. J Bone Joint Surg Br. 2011;93(1):96\u2013101. doi:https:\/\/doi.org\/10.1302\/0301-620X.93B1.25087. PubMed PMID: 21196551. Epub 2011\/01\/05.","DOI":"10.1302\/0301-620X.93B1.25087"},{"key":"4341_CR3","doi-asserted-by":"publisher","unstructured":"Kubiak EN, Fulkerson E, Strauss E, Egol KA. The evolution of locked plates. J Bone Joint Surg Am. 2006;88(Suppl 4):189\u2013200. doi:https:\/\/doi.org\/10.2106\/JBJS.F.00703. PubMed PMID: 17142448. Epub 2006\/12\/05.","DOI":"10.2106\/JBJS.F.00703"},{"key":"4341_CR4","doi-asserted-by":"publisher","unstructured":"Kolb W, Guhlmann H, Windisch C, Marx F, Kolb K, Koller H. Fixation of distal femoral fractures with the Less Invasive Stabilization System: a minimally invasive treatment with locked fixed-angle screws. J Trauma. 2008;65(6):1425-34. Epub 2008\/12\/17. doi: https:\/\/doi.org\/10.1097\/TA.0b013e318166d24a. PubMed PMID: 19077637.","DOI":"10.1097\/TA.0b013e318166d24a"},{"key":"4341_CR5","doi-asserted-by":"publisher","unstructured":"Fulkerson E, Tejwani N, Stuchin S, Egol K. Management of periprosthetic femur fractures with a first generation locking plate. Injury. 2007;38(8):965\u201372. doi:https:\/\/doi.org\/10.1016\/j.injury.2007.02.026. PubMed PMID: 17561020. Epub 2007\/06\/15.","DOI":"10.1016\/j.injury.2007.02.026"},{"issue":"1","key":"4341_CR6","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1080\/00016470410001708110","volume":"75","author":"F Fankhauser","year":"2004","unstructured":"Fankhauser F, Gruber G, Schippinger G, Boldin C, Hofer HP, Grechenig W, Szyszkowitz R. Minimal-invasive treatment of distal femoral fractures with the LISS (Less Invasive Stabilization System): a prospective study of 30 fractures with a follow up of 20 months. Acta Orthop Scand. 2004;75(1):56\u201360. Epub 2004\/03\/17. doi: 10.1080\/00016470410001708110. PubMed PMID: 15022808.","journal-title":"Acta Orthop Scand"},{"key":"4341_CR7","doi-asserted-by":"publisher","unstructured":"Haidukewych G, Sems SA, Huebner D, Horwitz D, Levy B. Results of polyaxial locked-plate fixation of periarticular fractures of the knee. J Bone Joint Surg Am. 2007;89(3):614\u201320. doi:https:\/\/doi.org\/10.2106\/JBJS.F.00510. PubMed PMID: 17332111. Epub 2007\/03\/03.","DOI":"10.2106\/JBJS.F.00510"},{"key":"4341_CR8","doi-asserted-by":"publisher","unstructured":"Kao FC, Tu YK, Su JY, Hsu KY, Wu CH, Chou MC. Treatment of distal femoral fracture by minimally invasive percutaneous plate osteosynthesis: comparison between the dynamic condylar screw and the less invasive stabilization system. J Trauma. 2009;67(4):719\u201326. doi:https:\/\/doi.org\/10.1097\/TA.0b013e31819d9cb2. PubMed PMID: 19820577. Epub 2009\/10\/13.","DOI":"10.1097\/TA.0b013e31819d9cb2"},{"key":"4341_CR9","doi-asserted-by":"publisher","unstructured":"Kregor PJ, Stannard J, Zlowodzki M, Cole PA, Alonso J. Distal femoral fracture fixation utilizing the Less Invasive Stabilization System (L.I.S.S.): the technique and early results. Injury. 2001;32 Suppl 3:SC32-47. Epub 2002\/03\/13. doi: https:\/\/doi.org\/10.1016\/s0020-1383(01)00182-6. PubMed PMID: 11888193.","DOI":"10.1016\/s0020-1383(01)00182-6"},{"key":"4341_CR10","doi-asserted-by":"publisher","unstructured":"Syed AA, Agarwal M, Giannoudis PV, Matthews SJ, Smith RM. Distal femoral fractures: long-term outcome following stabilisation with the LISS. Injury. 2004;35(6):599\u2013607. Epub 2004\/05\/12. doi: https:\/\/doi.org\/10.1016\/S0020-1383(03)00247-X. PubMed PMID: 15135280.","DOI":"10.1016\/S0020-1383(03)00247-X"},{"key":"4341_CR11","doi-asserted-by":"publisher","unstructured":"Weight M, Collinge C. Early results of the less invasive stabilization system for mechanically unstable fractures of the distal femur (AO\/OTA types A2, A3, C2, and C3). J Orthop Trauma. 2004;18(8):503\u20138. doi:https:\/\/doi.org\/10.1097\/00005131-200409000-00005. PubMed PMID: 15475845. Epub 2004\/10\/12.","DOI":"10.1097\/00005131-200409000-00005"},{"issue":"2","key":"4341_CR12","first-page":"74","volume":"70","author":"M Schutz","year":"2003","unstructured":"Schutz M, Muller M, Kaab M, Haas N. Less invasive stabilization system (LISS) in the treatment of distal femoral fractures. Acta Chir Orthop Traumatol Cech. 2003;70(2):74\u201382. Epub 2003\/06\/17. PubMed PMID: 12807039.","journal-title":"Acta Chir Orthop Traumatol Cech"},{"issue":"5","key":"4341_CR13","first-page":"250","volume":"33","author":"AR Ricci","year":"2004","unstructured":"Ricci AR, Yue JJ, Taffet R, Catalano JB, DeFalco RA, Wilkens KJ. Less Invasive Stabilization System for treatment of distal femur fractures. Am J Orthop (Belle Mead NJ). 2004;33(5):250\u20135. Epub 2004\/06\/16. PubMed PMID: 15195919.","journal-title":"Am J Orthop (Belle Mead NJ)"},{"key":"4341_CR14","doi-asserted-by":"publisher","unstructured":"Ricci WM, Loftus T, Cox C, Borrelli J. Locked plates combined with minimally invasive insertion technique for the treatment of periprosthetic supracondylar femur fractures above a total knee arthroplasty. J Orthop Trauma. 2006;20(3):190\u20136. doi:https:\/\/doi.org\/10.1097\/00005131-200603000-00005. PubMed PMID: 16648700. Epub 2006\/05\/02.","DOI":"10.1097\/00005131-200603000-00005"},{"key":"4341_CR15","doi-asserted-by":"publisher","unstructured":"Wong MK, Leung F, Chow SP. Treatment of distal femoral fractures in the elderly using a less-invasive plating technique. Int Orthop. 2005;29(2):117\u201320. doi:https:\/\/doi.org\/10.1007\/s00264-004-0609-3. PubMed PMID: 15703938; PMCID: PMC3474502. Epub 2005\/02\/11.","DOI":"10.1007\/s00264-004-0609-3"},{"key":"4341_CR16","doi-asserted-by":"publisher","unstructured":"Kregor PJ, Stannard JA, Zlowodzki M, Cole PA. Treatment of distal femur fractures using the less invasive stabilization system: surgical experience and early clinical results in 103 fractures. J Orthop Trauma. 2004;18(8):509\u201320. doi:https:\/\/doi.org\/10.1097\/00005131-200409000-00006. PubMed PMID: 15475846. Epub 2004\/10\/12.","DOI":"10.1097\/00005131-200409000-00006"},{"key":"4341_CR17","doi-asserted-by":"publisher","unstructured":"Schutz M, Muller M, Regazzoni P, Hontzsch D, Krettek C, Van der Werken C, Haas N. Use of the less invasive stabilization system (LISS) in patients with distal femoral (AO33) fractures: a prospective multicenter study. Arch Orthop Trauma Surg. 2005;125(2):102-8. Epub 2005\/02\/03. doi: https:\/\/doi.org\/10.1007\/s00402-004-0779-x. PubMed PMID: 15688230.","DOI":"10.1007\/s00402-004-0779-x"},{"key":"4341_CR18","doi-asserted-by":"crossref","unstructured":"Ebraheim NA, Liu J, Hashmi SZ, Sochacki KR, Moral MZ, Hirschfeld AG. High complication rate in locking plate fixation of lower periprosthetic distal femur fractures in patients with total knee arthroplasties. J Arthroplasty. 2012;27(5):809\u201313. doi: 10.1016\/j.arth.2011.08.007. PubMed PMID: 21964235.","DOI":"10.1016\/j.arth.2011.08.007"},{"key":"4341_CR19","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e3182070127","author":"CE Henderson","year":"2011","unstructured":"Henderson CE, Kuhl LL, Fitzpatrick DC, Marsh JL. Locking plates for distal femur fractures: is there a problem with fracture healing? J Orthop Trauma. 2011;25 Suppl 1:S8-14. Epub 2011\/02\/02. doi:https:\/\/doi.org\/10.1097\/BOT.0b013e3182070127. PubMed PMID: 21248560."},{"key":"4341_CR20","doi-asserted-by":"publisher","unstructured":"Streubel PN, Gardner MJ, Morshed S, Collinge CA, Gallagher B, Ricci WM. Are extreme distal periprosthetic supracondylar fractures of the femur too distal to fix using a lateral locked plate? J Bone Joint Surg Br. 2010;92(4):527\u201334. doi:https:\/\/doi.org\/10.1302\/0301-620X.92B3.22996. PubMed PMID: 20357329. Epub 2010\/04\/02.","DOI":"10.1302\/0301-620X.92B3.22996"},{"key":"4341_CR21","doi-asserted-by":"publisher","unstructured":"Lujan TJ, Henderson CE, Madey SM, Fitzpatrick DC, Marsh JL, Bottlang M. Locked plating of distal femur fractures leads to inconsistent and asymmetric callus formation. J Orthop Trauma. 2010;24(3):156\u201362. doi:https:\/\/doi.org\/10.1097\/BOT.0b013e3181be6720. PubMed PMID: 20182251. Epub 2010\/02\/26.","DOI":"10.1097\/BOT.0b013e3181be6720"},{"key":"4341_CR22","doi-asserted-by":"publisher","unstructured":"Rodriguez EK, Boulton C, Weaver MJ, Herder LM, Morgan JH, Chacko AT, Appleton PT, Zurakowski D, Vrahas MS. Predictive factors of distal femoral fracture nonunion after lateral locked plating: a retrospective multicenter case-control study of 283 fractures. Injury. 2014;45(3):554\u20139. doi:https:\/\/doi.org\/10.1016\/j.injury.2013.10.042. PubMed PMID: 24275357. Epub 2013\/11\/28.","DOI":"10.1016\/j.injury.2013.10.042"},{"key":"4341_CR23","doi-asserted-by":"publisher","unstructured":"Henderson CE, Lujan TJ, Kuhl LL, Bottlang M, Fitzpatrick DC, Marsh JL. 2010 mid-America Orthopaedic Association Physician in Training Award: healing complications are common after locked plating for distal femur fractures. Clin Orthop Relat Res. 2011;469(6):1757\u201365. doi:https:\/\/doi.org\/10.1007\/s11999-011-1870-6. PubMed PMID: 21424831; PMCID: PMC3094618. Epub 2011\/03\/23.","DOI":"10.1007\/s11999-011-1870-6"},{"key":"4341_CR24","doi-asserted-by":"publisher","unstructured":"Ricci WM, Streubel PN, Morshed S, Collinge CA, Nork SE, Gardner MJ. Risk factors for failure of locked plate fixation of distal femur fractures: an analysis of 335 cases. J Orthop Trauma. 2014;28(2):83\u20139. doi:https:\/\/doi.org\/10.1097\/BOT.0b013e31829e6dd0. PubMed PMID: 23760176. Epub 2013\/06\/14.","DOI":"10.1097\/BOT.0b013e31829e6dd0"},{"key":"4341_CR25","doi-asserted-by":"publisher","unstructured":"Chong AC, Friis EA, Ballard GP, Czuwala PJ, Cooke FW. Fatigue performance of composite analogue femur constructs under high activity loading. Ann Biomed Eng. 2007;35(7):1196 \u2013 205. Epub 2007\/03\/29. doi: https:\/\/doi.org\/10.1007\/s10439-007-9284-z. PubMed PMID: 17390224.","DOI":"10.1007\/s10439-007-9284-z"},{"issue":"4","key":"4341_CR26","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1115\/1.2746369","volume":"129","author":"ACM Chong","year":"2007","unstructured":"Chong ACM, Miller F, Buxton M, Friis EA. Fracture Toughness and Fatigue Crack Propagation Rate of Short Fiber Reinforced Epoxy Composites for Analogue Cortical Bone. J Biomech Eng. 2007;129(4):487\u201393. doi:https:\/\/doi.org\/10.1115\/1.2746369.","journal-title":"J Biomech Eng"},{"key":"4341_CR27","doi-asserted-by":"publisher","unstructured":"Heiner AD. Structural properties of fourth-generation composite femurs and tibias. J Biomech. 2008;41(15):3282\u20134. doi:https:\/\/doi.org\/10.1016\/j.jbiomech.2008.08.013. PubMed PMID: 18829031. Epub 2008\/10\/03.","DOI":"10.1016\/j.jbiomech.2008.08.013"},{"key":"4341_CR28","doi-asserted-by":"publisher","unstructured":"Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, Prokuski L, Sirkin MS, Ziran B, Henley B, Audige L. Fracture and dislocation classification compendium \u2013 2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma. 2007;21(10 Suppl):1\u2013133. doi:https:\/\/doi.org\/10.1097\/00005131-200711101-00001. PubMed PMID: 18277234. Epub 2008\/03\/07.","DOI":"10.1097\/00005131-200711101-00001"},{"key":"4341_CR29","doi-asserted-by":"publisher","unstructured":"Bottlang M, Schemitsch CE, Nauth A, Routt M Jr, Egol KA, Cook GE, Schemitsch EH. Biomechanical Concepts for Fracture Fixation. J Orthop Trauma. 2015;29(Suppl 12):28\u201333. doi:https:\/\/doi.org\/10.1097\/BOT.0000000000000467. PubMed PMID: 26584263; PMCID: PMC4654707. Epub 2015\/11\/20.","DOI":"10.1097\/BOT.0000000000000467"},{"key":"4341_CR30","doi-asserted-by":"publisher","unstructured":"Panteli M, Rodham P, Giannoudis PV. Biomechanical rationale for implant choices in femoral neck fracture fixation in the non-elderly. Injury. 2015;46(3):445\u201352. doi:https:\/\/doi.org\/10.1016\/j.injury.2014.12.031. PubMed PMID: 25597514. Epub 2015\/01\/20.","DOI":"10.1016\/j.injury.2014.12.031"},{"key":"4341_CR31","doi-asserted-by":"publisher","unstructured":"Gurusamy K, Parker MJ, Rowlands TK. The complications of displaced intracapsular fractures of the hip: the effect of screw positioning and angulation on fracture healing. J Bone Joint Surg Br. 2005;87(5):632\u20134. doi:https:\/\/doi.org\/10.1302\/0301-620X.87B5.15237. PubMed PMID: 15855363. Epub 2005\/04\/28.","DOI":"10.1302\/0301-620X.87B5.15237"},{"key":"4341_CR32","unstructured":"Riehl JT, Koval KJ, Langford JR, Munro MW, Kupiszewski SJ, Haidukewych GJ. Intramedullary nailing of subtrochanteric fractures\u2013does malreduction matter? Bull Hosp Jt Dis (2013). 2014;72(2):159 \u2013 63. Epub 2014\/08\/26. PubMed PMID: 25150344."},{"key":"4341_CR33","doi-asserted-by":"publisher","unstructured":"Clement ND, Goudie EB, Brooksbank AJ, Chesser TJ, Robinson CM. Smoking status and the Disabilities of the Arm Shoulder and Hand score are early predictors of symptomatic nonunion of displaced midshaft fractures of the clavicle. Bone Joint J. 2016;98-B(1):125 \u2013 30. Epub 2016\/01\/07. doi: https:\/\/doi.org\/10.1302\/0301-620X.98B1.36260. PubMed PMID: 26733525.","DOI":"10.1302\/0301-620X.98B1.36260"},{"key":"4341_CR34","first-page":"33","volume-title":"Skeletal Trauma: Basic Science, Management and Reconstruction","author":"SET Kakar","year":"2008","unstructured":"Kakar SET. The Biology and Enhancement of Skeletal Repair. In: Browner BD, editor. Skeletal Trauma: Basic Science, Management and Reconstruction. 4th ed. Philadelphia: W.B. Saunders; 2008. pp.\u00a033\u201350.","edition":"4"},{"key":"4341_CR35","doi-asserted-by":"publisher","unstructured":"Schmidt U, Penzkofer R, Bachmaier S, Augat P. Implant material and design alter construct stiffness in distal femur locking plate fixation: a pilot study. Clin Orthop Relat Res. 2013;471(9):2808\u201314. doi:https:\/\/doi.org\/10.1007\/s11999-013-2867-0. PubMed PMID: 23436162; PMCID: PMC3734410. Epub 2013\/02\/26.","DOI":"10.1007\/s11999-013-2867-0"},{"key":"4341_CR36","doi-asserted-by":"crossref","unstructured":"Mardian S, Schmolz W, Schaser KD, Duda GN, Heyland M. Interfragmentary lag screw fixation in locking plate constructs increases stiffness in simple fracture patterns. Clin Biomech (Bristol Avon). 2015;30(8):814\u20139. doi: 10.1016\/j.clinbiomech.2015.06.008. PubMed PMID: 26094776.","DOI":"10.1016\/j.clinbiomech.2015.06.008"},{"key":"4341_CR37","doi-asserted-by":"publisher","unstructured":"Mardian S, Schaser KD, Duda GN, Heyland M. Working length of locking plates determines interfragmentary movement in distal femur fractures under physiological loading. Clin Biomech (Bristol Avon). 2015;30(4):391\u20136. doi:https:\/\/doi.org\/10.1016\/j.clinbiomech.2015.02.006. PubMed PMID: 25716162. Epub 2015\/02\/27.","DOI":"10.1016\/j.clinbiomech.2015.02.006"},{"key":"4341_CR38","doi-asserted-by":"crossref","unstructured":"MacLeod AR, Simpson AH, Pankaj P. Reasons why dynamic compression plates are inferior to locking plates in osteoporotic bone: a finite element explanation. Comput Methods Biomech Biomed Engin. 2015;18(16):1818\u201325. doi: 10.1080\/10255842.2014.974580. PubMed PMID: 25473732.","DOI":"10.1080\/10255842.2014.974580"},{"key":"4341_CR39","doi-asserted-by":"publisher","unstructured":"Moazen M, Leonidou A, Pagkalos J, Marghoub A, Fagan MJ, Tsiridis E. Application of Far Cortical Locking Technology in Periprosthetic Femoral Fracture Fixation: A Biomechanical Study. J Arthroplasty. 2016;31(8):1849\u201356. doi:https:\/\/doi.org\/10.1016\/j.arth.2016.02.013. PubMed PMID: 26989031. Epub 2016\/03\/19.","DOI":"10.1016\/j.arth.2016.02.013"},{"key":"4341_CR40","doi-asserted-by":"publisher","unstructured":"Katthagen JC, Schwarze M, Warnhoff M, Voigt C, Hurschler C, Lill H. Influence of plate material and screw design on stiffness and ultimate load of locked plating in osteoporotic proximal humeral fractures. Injury. 2016;47(3):617\u201324. doi:https:\/\/doi.org\/10.1016\/j.injury.2016.01.004. PubMed PMID: 26804939. Epub 2016\/01\/26.","DOI":"10.1016\/j.injury.2016.01.004"},{"key":"4341_CR41","doi-asserted-by":"publisher","unstructured":"Beingessner D, Moon E, Barei D, Morshed S. Biomechanical analysis of the less invasive stabilization system for mechanically unstable fractures of the distal femur: comparison of titanium versus stainless steel and bicortical versus unicortical fixation. J Trauma. 2011;71(3):620\u20134. doi:https:\/\/doi.org\/10.1097\/TA.0b013e31820337c4. PubMed PMID: 21610539. Epub 2011\/05\/26.","DOI":"10.1097\/TA.0b013e31820337c4"},{"issue":"4","key":"4341_CR42","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1097\/BOT.0000000000000302","volume":"29","author":"MJ Beltran","year":"2015","unstructured":"Beltran MJ, Gary JL, Collinge CA. Management of distal femur fractures with modern plates and nails: state of the art. J Orthop Trauma. 2015;29(4):165\u201372. Epub 2015\/03\/21. doi: 10.1097\/BOT.0000000000000302. PubMed PMID: 25793566.","journal-title":"J Orthop Trauma"},{"key":"4341_CR43","doi-asserted-by":"publisher","unstructured":"Gwinner C, Mardian S, Droge T, Schulze M, Raschke MJ, Stange R. Bicortical screw fixation provides superior biomechanical stability but devastating failure modes in periprosthetic femur fracture care using locking plates. Int Orthop. 2015;39(9):1749\u201355. doi:https:\/\/doi.org\/10.1007\/s00264-015-2787-6. PubMed PMID: 25947899. Epub 2015\/05\/08.","DOI":"10.1007\/s00264-015-2787-6"},{"key":"4341_CR44","doi-asserted-by":"publisher","unstructured":"Cui S, Bledsoe JG, Israel H, Watson JT, Cannada LK. Locked plating of comminuted distal femur fractures: does unlocked screw placement affect stability and failure? J Orthop Trauma. 2014;28(2):90\u20136. doi:https:\/\/doi.org\/10.1097\/BOT.0b013e31829f9504. PubMed PMID: 23860132. Epub 2013\/07\/19.","DOI":"10.1097\/BOT.0b013e31829f9504"},{"key":"4341_CR45","doi-asserted-by":"crossref","unstructured":"Harvin WH, Oladeji LO, Della Rocca GJ, Murtha YM, Volgas DA, Stannard JP, Crist BD. Working length and proximal screw constructs in plate osteosynthesis of distal femur fractures. Injury. 2017;48(11):2597\u2013601. doi: 10.1016\/j.injury.2017.08.064. PubMed PMID: 28889934.","DOI":"10.1016\/j.injury.2017.08.064"},{"key":"4341_CR46","doi-asserted-by":"crossref","unstructured":"Kandemir U, Augat P, Konowalczyk S, Wipf F, von Oldenburg G, Schmidt U. Implant Material, Type of Fixation at the Shaft, and Position of Plate Modify Biomechanics of Distal Femur Plate Osteosynthesis. J Orthop Trauma. 2017;31(8):e241-e6. doi:\/BOT.0000000000000860. PubMed PMID: 28394844. Epub 2017\/04\/11.","DOI":"10.1097\/BOT.0000000000000860"}],"container-title":["BMC Musculoskeletal Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-021-04341-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12891-021-04341-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-021-04341-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T05:04:08Z","timestamp":1622783048000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmusculoskeletdisord.biomedcentral.com\/articles\/10.1186\/s12891-021-04341-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,4]]},"references-count":46,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["4341"],"URL":"https:\/\/doi.org\/10.1186\/s12891-021-04341-2","relation":{"references":[{"id-type":"uri","id":"","asserted-by":"subject"}]},"ISSN":["1471-2474"],"issn-type":[{"value":"1471-2474","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,4]]},"assertion":[{"value":"6 January 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 May 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 June 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Dr. Ara Nazarian is a Editorial Board Member.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"512"}}