How Many Proximal Screws Are Needed for a Stable Proximal Humerus Fracture Fixation?
- 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)
- 김효준; 신명진; Erica Kholinne; 서장현; 안덕우; 김지완; 고경환
- Issued Date
- 2021
- Type
- Article
- Keyword
- proximal humeral fracture; locking plate; number of screws; fixation failure; surgical 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
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- Medicine > Medicine
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