Biomechanical evaluation of hybrid double plate osteosynthesis using a locking plate and an inverted third tubular plate for the treatment of proximal humeral fractures

Autor: Theopold, Jan, Schleifenbaum, Stefan, Müller, Mirijam, Werner, Michael, Hammer, Niels, Josten, Christoph, Hepp, Pierre
Přispěvatelé: Publica
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
Critical Care and Emergency Medicine
Medical Implants
Bone and Mineral Metabolism
Materials Science
Material Properties
lcsh:Medicine
Bioengineering
Surgical and Invasive Medical Procedures
Research and Analysis Methods
Biochemistry
Stiffness
Fracture Fixation
Internal

Bone Density
Materials Testing
Medicine and Health Sciences
Mechanical Properties
Humans
lcsh:Science
Bone
Musculoskeletal System
Skeleton
Trauma Medicine
Aged
Mechanical Phenomena
lcsh:R
Biology and Life Sciences
Humerus
Biomechanical Phenomena
Biological Tissue
Metabolism
Bone Fracture
Connective Tissue
Specimen Preparation and Treatment
Physical Sciences
Shoulder Fractures
Engineering and Technology
lcsh:Q
Medical Devices and Equipment
Female
Anatomy
Traumatic Injury
Bone Plates
surgical and invasive method
Research Article
Biotechnology
Zdroj: PLoS ONE
PLoS ONE, Vol 13, Iss 10, p e0206349 (2018)
ISSN: 1932-6203
Popis: BACKGROUND:Treating proximal humerus fractures can be challenging because of large metaphyseal defects that conceal anatomical landmarks. In such cases, medial cortical support with, for example, calcar screws, is mandatory. Nevertheless, varus dislocations and implant failures in patients with impaired bone quality persist. Thus, the need for effective treatment of these patients exists. Hybrid double plate osteosynthesis was introduced as an alternative, yielding similar results as calcar screws. However, a biomechanical comparison of the stability of these two techniques is pending. METHODS:Cadaveric humeral specimens were treated with plate osteosynthesis and calcar screws (group 1, n = 9) or hybrid double plate osteosynthesis (group 2, n = 9) using a proximal humerus fracture model with a two-part fracture. Displacement, stiffness, failure mode, and ultimate load were examined biomechanically in a cyclic compressive-loading scenario. RESULTS:Although the hybrid double plate osteosynthesis (group 2) tended to confer higher stiffnesses than the medial support screws at higher cycles (group 1), this trend was below the level of significance. The displacement revealed non-significantly lower values for group 1 as compared with group 2 for cycles 50 and 2000, but at 5000 cycles, group 2 offered non-significantly lower displacement values than group 1. The ultimate load tended to be non-significantly higher in the hybrid double plate osteosynthesis group (group 2: 1342±369 N, group 1: 855±408 N). Both groups yielded similar failure rates, with the majority of failures in group 2 being gap closures (n = 8), whereas those in group 1 being plate dislocations (n = 4). CONCLUSIONS:The use of an additive plate osteosynthesis in the region of the bicipital groove may be a potential alternative to the previously-established method of using calcar screws. The biomechanical data obtained in this study suggests that hybrid double plate osteosynthesis is as rigid and robust as calcar screws.
Databáze: OpenAIRE
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