Comparison of screw trajectory on stability of oblique scaphoid fractures: a mechanical study.

Autor:	Faucher GK; Hand and Upper Extremity Surgery, The Emory Orthopaedic Center, Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, GA., Golden ML 3rd; Hand and Upper Extremity Surgery, The Emory Orthopaedic Center, Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, GA., Sweeney KR; Hand and Upper Extremity Surgery, The Emory Orthopaedic Center, Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, GA., Hutton WC; Hand and Upper Extremity Surgery, The Emory Orthopaedic Center, Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, GA., Jarrett CD; Hand and Upper Extremity Surgery, The Emory Orthopaedic Center, Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, GA. Electronic address: claudius.d.jarrett@emory.edu.
Jazyk:	angličtina
Zdroj:	The Journal of hand surgery [J Hand Surg Am] 2014 Mar; Vol. 39 (3), pp. 430-5.
DOI:	10.1016/j.jhsa.2013.12.015
Abstrakt:	Purpose: To determine whether a screw placed perpendicular to the fracture line in an oblique scaphoid fracture will provide fixation strength that is comparable with that of a centrally placed screw. Methods: Oblique osteotomies were made along the dorsal sulcus of 8 matched pairs of cadaveric scaphoids. One scaphoid from each pair was randomized to receive a screw placed centrally down the long axis. In the other scaphoid, a screw was placed perpendicular to the osteotomy. Each scaphoid underwent cyclic loading from 80 N to 120 N at 1 Hz. Cyclic loading was carried out until 2 mm of fracture displacement occurred or 4,000 cycles was reached. The specimens that reached the 4,000-cycle limit were then loaded to failure. Screw length, number of cycles, and load to failure were compared between the groups. Results: We found no difference in number of cycles or load to failure between the 2 groups. Screws placed perpendicular to the fracture line were significantly shorter than screws placed down the central axis. Conclusions: A perpendicularly placed screw provides equivalent strength to one placed along the central axis. Clinical Relevance: Compared with a screw placed centrally in an oblique scaphoid fracture, a screw placed perpendicular to the fracture line allows the use of a shorter screw without sacrificing strength of fixation. (Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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