6533b823fe1ef96bd127f660

RESEARCH PRODUCT

Screw fixation of radial head fractures: Compression screw versus lag screw—A biomechanical comparison

Klaus J. BurkhartPhilipp AppelmannPol Maria RommensTobias E. NowakWerner SternsteinLars P. Mueller

subject

medicine.medical_specialtyBone ScrewsElbowWeight-BearingFracture Fixation InternalRandom AllocationFixation (surgical)CadaverFracture fixationCadavermedicineHumansGeneral Environmental ScienceOrthodonticsOsteosynthesisbusiness.industryBiomechanicsmedicine.diseaseBiomechanical PhenomenaSurgeryPseudarthrosismedicine.anatomical_structureGeneral Earth and Planetary SciencesRadius FracturesbusinessCadaveric spasm

description

Abstract Introduction Secondary loss of reduction and pseudarthrosis due to unstable fixation methods remain challenging problems of surgical stabilisation of radial head fractures. The purpose of our study was to determine whether the 3.0 mm Headless Compression Screw (HCS) provides superior stability to the standard 2.0 mm cortical screw (COS). Materials and methods Eight pairs of fresh frozen human cadaveric proximal radii were used for this paired comparison. A standardised Mason II-Fracture was created with a fragment size of 1/3 of the radial head's articular surface that was then stabilised either with two 3.0 mm HCS (Synthes) or two 2.0 mm COS (Synthes) according to a randomisation protocol. The specimens were then loaded axially and transversely with 100 N each for 4 cycles. Cyclic loading with 1000 cycles as well as failure load tests were performed. The Wilcoxon test was used to assess statistically significant differences between the two groups. Results No statistical differences could be detected between the two fixation methods. Under axial loads the COS showed a displacement of 0.32 mm vs. 0.49 mm for the HCS. Under transverse loads the displacement was 0.25 mm for the COS vs. 0.58 mm for the HCS group. After 1000 cycles of axial loading there were still no significant differences. The failure load for the COS group was 291 N and 282 N for the HCS group. Conclusion No significant differences concerning the stability achieved by 3.0 mm HCS and the 2.0 mm COS could be detected in the experimental setup presented.

https://doi.org/10.1016/j.injury.2010.03.001