Cinzia Gaudelli1, Jérémie Ménard2, Jennifer Mutch1, G-Yves Laflamme1, Yvan Petit3, Dominique M Rouleau4. 1. Université de Montréal, Montréal, Canada; Hôpital du Sacré-Cœur de Montréal, Montréal, Canada. 2. Hôpital du Sacré-Cœur de Montréal Research Center, Montréal, Canada. 3. Department of Mechanical Engineering, École de technologie supérieure, Montréal, Canada. 4. Université de Montréal, Montréal, Canada; Hôpital du Sacré-Cœur de Montréal, Montréal, Canada. Electronic address: dominique.rouleau@umontreal.ca.
Abstract
BACKGROUND: This paper aims to determine the strongest fixation method for split type greater tuberosity fractures of the proximal humerus by testing and comparing three fixation methods: a tension band with No. 2 wire suture, a double-row suture bridge with suture anchors, and a manually contoured calcaneal locking plate. METHODS: Each method was tested on eight porcine humeri. A osteotomy of the greater tuberosity was performed 50° to the humeral shaft and then fixed according to one of three methods. The humeri were then placed in a testing apparatus and tension was applied along the supraspinatus tendon using a thermoelectric cooling clamp. The load required to produce 3mm and 5mm of displacement, as well as complete failure, was recorded using an axial load cell. FINDINGS: The average load required to produce 3mm and 5mm of displacement was 658N and 1112N for the locking plate, 199N and 247N for the double row, and 75N and 105N for the tension band. The difference between the three groups was significant (P<0.01). The average load to failure of the locking plate (810N) was significantly stronger than double row (456N) and tension band (279N) (P<0.05). The stiffness of the locking plate (404N/mm) was significantly greater than double row (71N/mm) and tension band (33N/mm) (P<0.01). INTERPRETATION: Locking plate fixation provides the strongest and stiffest biomechanical fixation for split type greater tuberosity fractures.
BACKGROUND: This paper aims to determine the strongest fixation method for split type greater tuberosity fractures of the proximal humerus by testing and comparing three fixation methods: a tension band with No. 2 wire suture, a double-row suture bridge with suture anchors, and a manually contoured calcaneal locking plate. METHODS: Each method was tested on eight porcine humeri. A osteotomy of the greater tuberosity was performed 50° to the humeral shaft and then fixed according to one of three methods. The humeri were then placed in a testing apparatus and tension was applied along the supraspinatus tendon using a thermoelectric cooling clamp. The load required to produce 3mm and 5mm of displacement, as well as complete failure, was recorded using an axial load cell. FINDINGS: The average load required to produce 3mm and 5mm of displacement was 658N and 1112N for the locking plate, 199N and 247N for the double row, and 75N and 105N for the tension band. The difference between the three groups was significant (P<0.01). The average load to failure of the locking plate (810N) was significantly stronger than double row (456N) and tension band (279N) (P<0.05). The stiffness of the locking plate (404N/mm) was significantly greater than double row (71N/mm) and tension band (33N/mm) (P<0.01). INTERPRETATION: Locking plate fixation provides the strongest and stiffest biomechanical fixation for split type greater tuberosity fractures.
Authors: Simon Thelen; Jan P Grassmann; Madeleine Schneider; Carina Jaekel; Dana M Meier; Marcel Betsch; Mohssen Hakimi; Michael Wild Journal: GMS Interdiscip Plast Reconstr Surg DGPW Date: 2022-05-23
Authors: Cheng Long; Zhou Xiang; Gang Zhong; Shiqiang Cen; Song Kuang; Changchun He; Tao Jiang; Fuguo Huang Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi Date: 2019-04-15