Biomechanical comparison of headless antegrade screw versus retrograde cortical screw for coronoid fracture fixation (EXPERIMENTAL STUDY)
Objective: Posterior-to-anterior directed screws are stronger than anterior-to-posterior directed screws for coronoid fracture fixation. Anterior approaches that facilitate direct reduction and fixation of coronoid fractures have been described. The present study was based on the hypothesis that anterior-to-posterior headless screw (Acutrak Mini® 3.5 mm × 26 mm, Acumed, Hillsboro, Oregon, USA) fixation of coronoid fractures would be as strong as posterior-to-anterior 2.7 mm Association for Osteosynthesis (AO) cortical screw fixation. Methods: This study included 14 ulnas obtained from 14 formalin-preserved adult cadavers. Coronoid type 2 fractures were created and fixed randomly using anterior-to-posterior headless screws (antegrade group) and posterior-to-anterior 2.7 mm AO cortical screws (retrograde group). The experimental constructs were loaded until 2 mm of displacement. Failure load (N), fixation stiffness (Nmm1), and indentation stiffness were calculated. Results: Failure load was higher in the retrograde screw group (p=0.03), whereas loading stiffness values of the fixation devices and bones did not differ between the 2 fixation groups (p>0.05). Conclusion: The present study failed to show that anterior-to-posterior directed headless screw fixation of coronoid fractures could adequately replace posterior-to-anterior placed screw fixation.
___
1. Clarke SE, Lee SY, Raphael JR. Coronoid fixation using suture anchors. Hand (N Y) 2009;4:15660.2. McKay PL, Katarincic JA. Fractures of the proximal ulna olecranon and coronoid fractures. Hand Clin 2002;18:43 53.
3. ODriscoll SW, Jupiter JB, Cohen MS, Ring D, McKee MD. Difficult elbow fractures: pearls and pitfalls. Instr Course Lect 2003;52:11334.
4. ODriscoll S. Coronoid fractures. In: Norris TR, editor. Orthopedic knowledge update: shoulder and elbow. Rosemont, IL: American Academy of Orthpaedic Surgeons; 2002. p. 37984.
5. Cohen MS. Fractures of the coronoid process. Hand Clin 2004;20:44353.
6. Doornberg JN, van Duijn J, Ring D. Coronoid fracture height in terrible-triad injuries. J Hand Surg Am 2006;31:7947.
7. Moon JG, Zobitz ME, An KN, ODriscoll SW. Optimal screw orientation for fixation of coronoid fractures. J Orthop Trauma 2009;23:27780.
8. Kang LQ, Ding ZQ, Sha M, Hong JY, Chen W. A minimally invasive anterior approach to reduction and screw fixation of coronoid fractures. J Hand Surg Eur Vol 2010;35:2247.
9. Zhang C, Zhong B, Luo CF. Treatment strategy of terrible triad of the elbow: experience in Shanghai 6th Peoples Hospital. Injury 2014;45:9428.
10. Han SH, Yoon HK, Rhee SY, Lee JK. Anterior approach for fixation of isolated type III coronoid process fracture. Eur J Orthop Surg Traumatol 2013;23:395405.
11. Hartzler RU, Llusa-Perez M, Steinmann SP, Morrey BF, Sanchez-Sotelo J. Transverse coronoid fracture: when does it have to be fixed? Clin Orthop Relat Res 2014;472:2068 74.
12. Morrey BF. Complex instability of the elbow. Instr Course Lect 1998;47:15764.
13. Ring D. Fractures of the coronoid process of the ulna. J Hand Surg Am 2006;31:167989.
14. McKee MD, Pugh DM, Wild LM, Schemitsch EH, King GJ. Standard surgical protocol to treat elbow dislocations with radial head and coronoid fractures. Surgical technique. J Bone Joint Surg Am 2005;87 Suppl 1(Pt 1):22 32.
15. Garofalo R, Bollmann C, Kombot C, Moretti B, Borens O, Mouhsine E. Minimal invasive surgery for coronoid fracture: technical note. Knee Surg Sports Traumatol Arthrosc 2005;13:60811.
16. Reichel LM, Milam GS, Reitman CA. Anterior approach for operative fixation of coronoid fractures in complex elbow instability. Tech Hand Up Extrem Surg 2012;16:98104.
17. Elkowitz SJ, Kubiak EN, Polatsch D, Cooper J, Kummer FJ, Koval KJ. Comparison of two headless screw designs for fixation of capitellum fractures. Bull Hosp Jt Dis 2003;61:1236.
18. Hausman MR, Klug RA, Qureshi S, Goldstein R, Parsons BO. Arthroscopically assisted coronoid fracture fixation: a preliminary report. Clin Orthop Relat Res 2008;466:314752.
19. Sanders R, Haidukewych GJ, Milne T, Dennis J, Latta LL. Minimal versus maximal plate fixation techniques of the ulna: the biomechanical effect of number of screws and plate length. J Orthop Trauma 2002;16:16671.
20. Ouellette EA, Dennis JJ, Latta LL, Milne EL, Makowski AL. The role of soft tissues in plate fixation of proximal phalanx fractures. Clin Orthop Relat Res 2004;418:2138.
21. Osada D, Fujita S, Tamai K, Iwamoto A, Tomizawa K, Saotome K. Biomechanics in uniaxial compression of three distal radius volar plates. J Hand Surg Am 2004;29:44651.
22. Burkhart KJ, Mueller LP, Krezdorn D, Appelmann P, Prommersberger KJ, Sternstein W, et al. Stability of radial head and neck fractures: a biomechanical study of six fixation constructs with consideration of three locking plates. J Hand Surg Am 2007;32:156975.
- ISSN: 1017-995X
- Başlangıç: 2015
- Yayıncı: Türk Ortopedi ve Travmatoloji Derneği
Sayıdaki Diğer Makaleler
Levent ALTINEL, MEHMET SERHAN ER, Emre KAÇAR, Recep Abdullah ERTEN
Evaluation of an unusual ossicle by multi-detector computed tomography: Oppenheimer's ossicle
IŞIL BAŞARA AKIN, CANAN ALTAY, Sinem GEZER, Ali BALCI
İbrahim TUNCAY, Kerem BİLSEL, Mehmet ELMADAĞ, ÖMER FARUK ERKOÇAK, Murat AŞÇI, Cengiz ŞEN
Mehmet Ali ACAR, Ali GÜLEÇ, ÖMER FARUK ERKOÇAK, GÜNEY YILMAZ, Fatih DURGUT, Mehmet ELMADAĞ
Fracture-dislocations of the proximal ulna
Arel GERELİ, Ufuk NALBANTOĞLU, GÖKSEL DİKMEN, Mustafa SEYHAN, Metin TÜRKMEN
Early surgery is feasible in patients with hip fractures who are on clopidogrel therapy
SİNAN ZEHİR, Regayip ZEHİR, Taner SARAK
Pınar SAYIN, Hale DOBRUCALI, Hacer Şebnem TÜRK, Tolga TOTOZ, Canan Tülay IŞIL, Ayşe HANCI
Zhenhai WANG, Wenqing QU, Dan WANG, Zhiyong ZHOU, Min YU, Dongsheng ZHOU
A detailed analysis of messages posted on the Turk-Orthopod' mailing list over a 13-year period
Adil TURAN, Mehmet ARAZİ, Ferhat GÜLER, Selahattin ÖZYÜREK, Özkan KÖSE, Fatih DUYGUN