Surgical fixation of midshaft clavicle fractures : A systematic review of biomechanical studies
| Autor: | Egbert J. M. M. Verleisdonk, Bart J. Burger, Roderick M. Houwert, Olivier A. van der Meijden, DirkJan Veeger, Mark van Heijl, M. H. J. Hulsmans |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Fixation stability
SDG 16 - Peace Clavicle fracture Bone Screws Failure law.invention Stiffness Intramedullary rod 03 medical and health sciences Fracture Fixation Internal Fractures Bone 0302 clinical medicine law Superior Fracture fixation Materials Testing Intramedullary Medicine Humans Biomechanics Orthopedics and Sports Medicine 030212 general & internal medicine Surgical treatment Biomechanical General Environmental Science Plate fixation Orthodontics 030222 orthopedics business.industry SDG 16 - Peace Justice and Strong Institutions Pin Fixation (psychology) Clavicle Justice and Strong Institutions Biomechanical Phenomena medicine.anatomical_structure Treatment Outcome Clinical relevance Emergency Medicine General Earth and Planetary Sciences business Bone Plates |
| Zdroj: | Injury, 49(4), 753. Elsevier Limited Hulsmans, M H, van Heijl, M, Houwert, R M, Burger, B J, Verleisdonk, E J M, Veeger, D J & van der Meijden, O A 2018, ' Surgical fixation of midshaft clavicle fractures : A systematic review of biomechanical studies ', Injury, vol. 49, no. 4, pp. 753-765 . https://doi.org/10.1016/j.injury.2018.02.017 |
| ISSN: | 0020-1383 |
| DOI: | 10.1016/j.injury.2018.02.017 |
| Popis: | Purpose Surgical treatment of displaced midshaft clavicle fractures requires a decision between plate fixation and intramedullary (IM) fixation. Numerous studies report on the biomechanical properties of various repair constructs. The goal of this systematic review was to provide an overview of studies describing the biomechanical properties of the most commonly used surgical fixations of midshaft clavicle fractures. Additionally, we aimed to translate these biomechanical results into clinically relevant conclusions. Methods A computer-aided search of the EMBASE and PudMed/MEDLINE databases was conducted. Studies included for review compared biomechanical properties of plate fixation with IM fixation and superiorly positioned plates with anteroinferiorly positioned plates for midshaft clavicle fractures. Results Fifteen studies were eligible for inclusion. Plate fixation seemed to form a more robust construct than IM fixation in terms of stiffness and failure loading. The remaining clavicle was stronger after removal of the IM device than after removal of the plate. Superior plating of transverse fractures generally seemed to provide greater stiffness and strength during bending loads than anteroinferior plating did. The absence of cortical alignment in wedge and comminuted fractures directly influenced the fixation stability for both IM fixation and plate fixation, regardless of location. Conclusion Each type of fracture fixation has biomechanical advantages and disadvantages. However, exact thresholds of stiffness for inducing healing and failure strength to withstand refractures are unknown. The clinical relevance of the biomechanical studies may be arguable. Since none of the studies investigate the effect of tissue adaptation over time they should be interpreted with caution. |
| Databáze: | OpenAIRE |
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