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Hawker et al: The Effect of Locking Head Inserts on the Biomechanical Properties of a 3.5-mm Broad Locking Compression Plate When Used in an Open Fracture-Gap Model
Veterinary and Comparative Orthopaedics and Traumatology 4, 2025

🔍 Key Findings

  • Adding Locking Head Inserts (LHI) to a 3.5-mm LCP had no effect on plate strain, stiffness, or deformation in an open fracture gap model.
  • Peak strain consistently occurred at the Combi-hole over the fracture gap, with values up to ~1837 µε.
  • No significant difference in strain was found across configurations with 0, 3, or 9 LHI (p = 0.847).
  • Construct stiffness and compressive displacement also remained unchanged regardless of LHI count (p = 0.311 and 0.069 respectively).
  • Study contradicted the hypothesis that LHI would reduce strain and increase stiffness under biologic loading.
  • Combi-hole design may limit the efficacy of LHI, as LHI only fill the locking portion, not the compression side where strain peaks.
  • Implant fatigue risk remains highest over unfilled screw holes, especially over fracture sites—confirming previous failure patterns.
  • Surgeons should consider alternative methods to reduce strain when facing high implant load scenarios.

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Hawker et al: The Effect of Locking Head Inserts on the Biomechanical Properties of a 3.5-mm Broad Locking Compression Plate When Used in an Open Fracture-Gap Model
Veterinary and Comparative Orthopaedics and Traumatology 4, 2025

🔍 Key Findings

  • Adding Locking Head Inserts (LHI) to a 3.5-mm LCP had no effect on plate strain, stiffness, or deformation in an open fracture gap model.
  • Peak strain consistently occurred at the Combi-hole over the fracture gap, with values up to ~1837 µε.
  • No significant difference in strain was found across configurations with 0, 3, or 9 LHI (p = 0.847).
  • Construct stiffness and compressive displacement also remained unchanged regardless of LHI count (p = 0.311 and 0.069 respectively).
  • Study contradicted the hypothesis that LHI would reduce strain and increase stiffness under biologic loading.
  • Combi-hole design may limit the efficacy of LHI, as LHI only fill the locking portion, not the compression side where strain peaks.
  • Implant fatigue risk remains highest over unfilled screw holes, especially over fracture sites—confirming previous failure patterns.
  • Surgeons should consider alternative methods to reduce strain when facing high implant load scenarios.

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Multiple Choice Questions on this study

In Hawker 2025 et al., on locking head inserts, what did the authors conclude regarding high-strain construct scenarios?

A. Use 3-point bending to reduce load
B. Select plates with longer working lengths
C. Add more locking screws proximally
D. Consider alternate strain-reduction strategies
E. Always add LHI to central holes

Answer: Consider alternate strain-reduction strategies

Explanation: LHI did not reduce strain in this model; authors recommend considering other methods for high load conditions.
In Hawker 2025 et al., on locking head inserts, where was peak strain localized during testing?

A. At screw hole #1
B. At the end screw holes
C. Over the fracture defect
D. Under the central insert
E. At the mid-plate junction

Answer: Over the fracture defect

Explanation: Strain was consistently highest over the Combi-hole spanning the simulated fracture gap.
In Hawker 2025 et al., on locking head inserts, what was the impact of LHI on plate strain in a fracture-gap model?

A. Significant reduction in strain
B. Strain reduced only at gauge 3
C. No measurable effect
D. Strain doubled with 9 LHI
E. Strain reduced only with torque > 6 Nm

Answer: No measurable effect

Explanation: No statistically significant change in strain was observed with any LHI configuration.
In Hawker 2025 et al., on locking head inserts, why might LHI fail to reduce strain in LCP Combi-holes?

A. They engage 360° with the threads
B. They cause stress risers at locking side
C. They fill only the compression component
D. They do not engage the compression side
E. They seal the plate’s curvature

Answer: They do not engage the compression side

Explanation: Because LHI only fill the locking portion of the Combi-hole, strain at the compression side remains unaffected.
In Hawker 2025 et al., on locking head inserts, what effect did LHI have on axial stiffness and displacement?

A. Increased both
B. Increased stiffness only
C. Reduced stiffness slightly
D. No significant effect
E. Reduced displacement only

Answer: No significant effect

Explanation: No statistical differences in axial stiffness or deformation were noted between groups.

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