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 |
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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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