VCOT March 2025 – Ortho Part 2: Plate Removal Risk & Why 12 Holes Matter
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About this listen
In this Simini Small Animal Surgery Podcast episode, we wrap up the orthopedic coverage from the March 2025 issue of VCOT with two studies that dig deep into fracture recurrence risk and the limits of plate length compromises. These insights are must-knows for surgeons weighing implant removal decisions or choosing between shorter vs. longer constructs in MIPO.
We cover:
✅ Muroi et al. — A retrospective study of 181 radial-ulnar repairs in toy breed dogs, analyzing outcomes of plate retention vs. removal. The refracture rate quadrupled from 3.5% (retained) to 12.5% (removed), with every fracture occurring at the original site, confirming implant-induced osteoporosis (IIO). Use of pixel value ratio (PVR) and screw-to-bone diameter ratio (SBDR) > 0.4 were strong predictors of failure and highlight the importance of radiographic density—not just fracture line healing—when planning implant removal
✅ Trefny et al. — A biomechanical study testing plate length vs. construct stiffness using 3.5 mm LCPs across 6-, 8-, 10-, and 12-hole variants in a tibial gap model. The results? Only the 12-hole plate reached a meaningful increase in construct stiffness and reduced strain on bone and implant. Shorter constructs (even 10-hole) failed to reduce fatigue risk, emphasizing that an 80% plate-to-bone ratio is the biomechanical threshold surgeons should aim for
🎓 Journal Articles Discussed:
- Muroi et al. — A Retrospective Study of Risk Factors Associated with Refracture after Repair of Radial–Ulnar Fractures in Small-Breed Dogs
- Trefny et al. — Effect of Plate Length on Construct Stiffness and Strain in a Synthetic Short-Fragment Fracture Gap Model Stabilized with a 3.5-mm Locking Compression Plate
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