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How Many Proximal Screws Are Needed for a Stable Proximal Humerus Fracture Fixation?

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Abstract
Purpose: 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.
Author(s)
김효준신명진Erica Kholinne서장현안덕우김지완고경환
Issued Date
2021
Type
Article
Keyword
proximal humeral fracturelocking platenumber of screwsfixation failuresurgical neck fracture
DOI
10.1177/2151459321992744
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8653
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_3413dc7b767347e39cc27e88b2e45945&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,How%20Many%20Proximal%20Screws%20Are%20Needed%20for%20a%20Stable%20Proximal%20Humerus%20Fracture%20Fixation%3F&offset=0&pcAvailability=true
Publisher
GERIATRIC ORTHOPAEDIC SURGERY REHABILITATION
Location
미국
Language
영어
ISSN
2151-4585
Citation Volume
12
Citation Number
0
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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