Bone tunnel placement influences shear stresses at the coracoid process after coracoclavicular ligament reconstruction: a finite element study and radiological analysis
العنوان: | Bone tunnel placement influences shear stresses at the coracoid process after coracoclavicular ligament reconstruction: a finite element study and radiological analysis |
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المؤلفون: | Benjamin Bockmann, L. Dankl, G. Kucinskaite, A. Kumar, J. J. Timothy, G. Meschke, A. J. Venjakob, T. L. Schulte |
المصدر: | Archives of Orthopaedic and Trauma Surgery, 143 (2) |
بيانات النشر: | Springer Science and Business Media LLC, 2022. |
سنة النشر: | 2022 |
مصطلحات موضوعية: | Shear stress, AC joint repair, Shoulder arthroscopy, Finite element analysis, Coracoid fracture, Orthopedics and Sports Medicine, Surgery, General Medicine |
الوصف: | Introduction Coracoid fractures after arthroscopic treatment of acromioclavicular (AC) joint separations lead to poor clinical outcomes. In this study, different configurations of bone tunnels in the lateral clavicle and coracoid were examined concerning the amount of stress induced in the coracoid. Methods An authentic 3D finite element model of an ac joint was established. Three 2.4 mm bone tunnels were inserted in the lateral clavicle, which were situated above, medially and laterally of the coracoid. Then, two 2.4 mm bone tunnels were inserted in the latter, each simulating a proximal and a distal suture button position. Von Mises stress analyses were performed to evaluate the amount of stress caused in the coracoid process by the different configurations. Then, a clinical series of radiographs was examined, the placement of the clavicle drill hole was analyzed and the number of dangerous configurations was recorded. Results The safest configuration was a proximal tunnel in the coracoid combined with a lateral bone tunnel in the clavicle, leading to an oblique traction at the coracoid. A distal bone tunnel in the coracoid and perpendicular traction as well as a proximal tunnel in the coracoid with medial traction caused the highest stresses. Anatomical placement of the clavicle drill hole does lead to configurations with smaller stresses. Conclusion The bone tunnel placement with the smallest amount of shear stresses was found when the traction of the suture button was directed slightly lateral, towards the AC joint. Anatomical placement of the clavicle drill hole alone was not sufficient in preventing dangerous configurations. Archives of Orthopaedic and Trauma Surgery, 143 (2) ISSN:0936-8051 ISSN:0344-8444 ISSN:1434-3916 |
وصف الملف: | application/application/pdf |
تدمد: | 1434-3916 0936-8051 0344-8444 |
URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3b1135418f0651bff456e254f4cf935e https://doi.org/10.1007/s00402-022-04382-9 |
حقوق: | OPEN |
رقم الأكسشن: | edsair.doi.dedup.....3b1135418f0651bff456e254f4cf935e |
قاعدة البيانات: | OpenAIRE |
تدمد: | 14343916 09368051 03448444 |
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