دورية أكاديمية
أعرض في EDS

Is Bridge Plating of Comminuted Humeral Shaft Fractures Advantageous When Using Compression Plates with Three versus Two Screws per Fragment? A Biomechanical Cadaveric Study.

التفاصيل البيبلوغرافية
العنوان: Is Bridge Plating of Comminuted Humeral Shaft Fractures Advantageous When Using Compression Plates with Three versus Two Screws per Fragment? A Biomechanical Cadaveric Study.
المؤلفون: Gomes GS; AO Research Institute Davos, Davos, Switzerland., Zderic I; AO Research Institute Davos, Davos, Switzerland., Ahrend MD; AO Research Institute Davos, Davos, Switzerland.; Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard-Karls University of Tübingen, Tübingen, Germany., Kojima KE; Institute of Orthopedics and Traumatology, University of Sao Paulo, Brazil., Varga P; AO Research Institute Davos, Davos, Switzerland., Belangero WD; Department of Orthopedics and Traumatology, Faculty of Medical Sciences, State University of Campinas, Sao Paulo, Brazil., Richards G; AO Research Institute Davos, Davos, Switzerland., Lambert SM; Department of Trauma and Orthopaedics, University College London Hospital, London, UK., Gueorguiev B; AO Research Institute Davos, Davos, Switzerland.
المصدر: BioMed research international [Biomed Res Int] 2021 Mar 06; Vol. 2021, pp. 6649712. Date of Electronic Publication: 2021 Mar 06 (Print Publication: 2021).
نوع المنشور: Comparative Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: Hindawi Pub. Co Country of Publication: United States NLM ID: 101600173 Publication Model: eCollection Cited Medium: Internet ISSN: 2314-6141 (Electronic) NLM ISO Abbreviation: Biomed Res Int Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York, NY : Hindawi Pub. Co.
مواضيع طبية MeSH: Bone Plates* , Bone Screws* , Fracture Fixation, Internal* , Humeral Fractures*/pathology , Humeral Fractures*/surgery , Humerus*/pathology , Humerus*/surgery , Prosthesis Design*, Aged ; Cadaver ; Female ; Humans ; Male ; Middle Aged
مستخلص: Background: Minimally invasive plate osteosynthesis (MIPO) is one of the generally accepted surgical techniques for the treatment of humeral shaft fractures. However, despite the high bone union rate, a variety of complications are still prevailing. Moreover, the current literature lacks data comparing the anterolateral MIPO approach using dynamic compression plates accommodating different numbers of screws. The aim of this study was to analyze the biomechanical performance of comminuted humeral shaft fractures fixed with dynamic compression plates using either two or three screws per fragment.
Methods: Six pairs of fresh-frozen human cadaveric humeri from donors aged 66.8 ± 5.2 years were randomized to two paired study groups for simulation of bridge-plated comminuted shaft fracture type AO/OTA 12-C1/2/3 without interfragmentary bony support, using a dynamic compression plate positioned on the anterolateral surface and fixed with two (group 1) or three (group 2) screws per fragment. All specimens underwent nondestructive quasistatic biomechanical testing under lateral bending, anterior bending, axial bending, and torsion in internal rotation, followed by progressively increasing cyclic torsional loading in internal rotation until failure.
Results: Initial stiffness of the plated specimens in lateral bending, anterior bending, axial bending, and torsion was not significantly different between the groups ( P ≥ 0.22). However, cycles to 10°, 15°, and 20° torsional deformation and cycles to construct failure were significantly higher in group 2 compared with group 1 ( P ≤ 0.03).
Conclusions: From a biomechanical perspective, no significant superiority is identified in terms of primary stability when using two or three screws per fragment for bridge compression plating of comminuted humeral shaft fractures. However, three-screw configurations provide better secondary stability and maintain it with a higher resistance towards loss of reduction under dynamic loading. Therefore, the use of a third screw may be justified when such better secondary stability is required.
Competing Interests: The authors declare that they have no conflicts of interest.
(Copyright © 2021 Guilherme Seva Gomes et al.)
References: Injury. 2003 Nov;34 Suppl 2:B63-76. (PMID: 14580987)
J Bone Joint Surg Am. 2006 Sep;88(9):1962-7. (PMID: 16951112)
J Orthop Res. 2003 Nov;21(6):1011-7. (PMID: 14554213)
Clin Orthop Relat Res. 2000 Aug;(377):235-40. (PMID: 10943207)
Am J Orthop (Belle Mead NJ). 2011 Feb;40(2):E20-5. (PMID: 21720590)
Arch Orthop Trauma Surg. 2003 Apr;123(2-3):74-81. (PMID: 12721684)
Bone Joint Res. 2012 Jun 01;1(6):118-24. (PMID: 23610681)
J Orthop Trauma. 2005 Oct;19(9):597-603. (PMID: 16247303)
Int Orthop. 2010 Oct;34(7):1025-31. (PMID: 19730860)
Clin Biomech (Bristol, Avon). 2000 Jun;15(5):315-21. (PMID: 10758291)
Int Orthop. 2010 Dec;34(8):1297-305. (PMID: 19844708)
J Orthop Trauma. 1996;10(3):204-8. (PMID: 8667113)
J Orthop Trauma. 2010 Apr;24(4):207-11. (PMID: 20335752)
Trials. 2013 Aug 07;14:246. (PMID: 23924198)
Injury. 1999 Nov;30(9):591-8. (PMID: 10707226)
Injury. 2005 Apr;36(4):530-8. (PMID: 15755436)
J Trauma. 2006 Apr;60(4):830-5. (PMID: 16612304)
Injury. 2010 Jun;41(6):652-6. (PMID: 20236642)
J Trauma. 2011 Feb;70(2):358-65. (PMID: 20526207)
J Orthop Trauma. 2002 Mar;16(3):166-71. (PMID: 11880779)
J Bone Joint Surg Am. 1986 Sep;68(7):960-70. (PMID: 3745259)
Int Orthop. 2009 Apr;33(2):543-7. (PMID: 18317756)
Clin Biomech (Bristol, Avon). 2007 Dec;22(10):1049-62. (PMID: 17904257)
Orthopedics. 1989 Feb;12(2):219-26. (PMID: 2922359)
J Orthop Trauma. 2008 Nov-Dec;22(10):709-15. (PMID: 18978547)
J Shoulder Elbow Surg. 2011 Jul;20(5):833-44. (PMID: 21393016)
Proc Inst Mech Eng H. 2000;214(5):541-55. (PMID: 11109862)
J Biomech. 2010 Sep 17;43(13):2493-500. (PMID: 20538279)
J Orthop Trauma. 2011 Jun;25(6):340-6. (PMID: 21577069)
BMC Musculoskelet Disord. 2010 May 21;11:95. (PMID: 20492707)
J Orthop Trauma. 1991;5(1):14-20. (PMID: 2023038)
Injury. 2003 Nov;34 Suppl 2:B11-9. (PMID: 14580982)
J Biomech. 2007;40(10):2139-49. (PMID: 17169364)
Rev Chir Orthop Reparatrice Appar Mot. 2000 Jun;86(4):346-59. (PMID: 10880934)
Injury. 2004 Jun;35(6):587-95. (PMID: 15135278)
Int Orthop. 2009 Dec;33(6):1719-23. (PMID: 18704415)
Clin Biomech (Bristol, Avon). 2009 Feb;24(2):203-9. (PMID: 19070409)
J Orthop Trauma. 2011 Jul;25(7):406-13. (PMID: 21637120)
J Orthop Trauma. 2012 Apr;26(4):216-21. (PMID: 22068207)
Clin Biomech (Bristol, Avon). 2009 Jan;24(1):53-8. (PMID: 19012997)
تواريخ الأحداث: Date Created: 20210322 Date Completed: 20210525 Latest Revision: 20220421
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC7960035
DOI: 10.1155/2021/6649712
PMID: 33748273
قاعدة البيانات: MEDLINE
الوصف
تدمد:2314-6141
DOI:10.1155/2021/6649712