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How Many Proximal Screws Are Needed for a Stable Proximal Humerus Fracture Fixation?
| Content Provider | SAGE Publishing |
|---|---|
| Author | Kim, Hyojune Shin, Myung Jin Kholinne, Erica Seo, Janghyeon Ahn, Duckwoo Kim, Ji Wan Koh, Kyoung Hwan |
| Copyright Year | 2021 |
| Abstract | This biomechanical study investigates the optimal number of proximal screws for stable fixation of a 2-part proximal humerus fracture model with a locking plate.Methods:Twenty-four proximal humerus fracture models were included in the study. An unstable 2-part fracture was created and fixed by a locking plate. Cyclic loading and load-to-failure tests were used for the following 4 groups based on the number of screws used: 4-screw, 6-screw, 7-screw, and 9-screw groups. Interfragmentary gaps were measured following cyclic loading and compared. Consequently, the load to failure, maximum displacement, stiffness, and mode of failure at failure point were compared.Results:The interfragmentary gaps for the 4-screw, 6-screw, 7-screw, and 9-screw groups were significantly reduced by 0.24 ± 0.09 mm, 0.08 ± 0.06 mm, 0.05 ± 0.01 mm, and 0.03 ± 0.01 mm following 1000 cyclic loading, respectively. The loads to failure were significantly different between the groups with the 7-screw group showing the highest load to failure. The stiffness of the 7-screw group was superior compared with the 6-screw, 9-screw, and 4-screw groups. The maximum displacement before failure showed a significant difference between the comparative groups with the 4-screw group having the lowest value. The 7-screw group had the least structural failure rate (33.3%).Conclusion:At least 7 screws would be optimal for proximal fragment fixation of proximal humerus fractures with medial comminution to minimize secondary varus collapse or fixation failure.Level of Evidence:Basic science study. |
| Related Links | https://journals.sagepub.com/doi/pdf/10.1177/2151459321992744?download=true |
| ISSN | 21514593 |
| Volume Number | 12 |
| Journal | Geriatric Orthopaedic Surgery & Rehabilitation (GOS) |
| e-ISSN | 21514593 |
| DOI | 10.1177/2151459321992744 |
| Language | English |
| Publisher | Sage Publications CA |
| Publisher Date | 2021-02-09 |
| Publisher Place | Los Angeles |
| Access Restriction | Open |
| Rights Holder | © The Author(s) 2021 |
| Subject Keyword | fixation failure locking plate surgical neck fracture proximal humeral fracture number of screws |
| Content Type | Text |
| Resource Type | Article |
| Subject | Orthopedics and Sports Medicine Rehabilitation Surgery Geriatrics and Gerontology |
