Frank Martetschläger1, Tim Saier2, Annabelle Weigert3, Elmar Herbst3, Martin Winkler4, Julia Henschel4, Peter Augat5, Andreas B Imhoff6, Sepp Braun3. 1. Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, TU Munich, Munich, Germany; Center for Shoulder and Elbow Surgery, ATOS Clinic Munich, Munich, Germany. 2. Trauma Center Murnau, Berufsgenossenschaftliche Klinik Murnau, Murnau, Germany; Institute of Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany. 3. Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, TU Munich, Munich, Germany. 4. Institute of Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany. 5. Institute of Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany; Institute of Biomechanics, Paracelsus Medical University, Salzburg, Austria. 6. Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, TU Munich, Munich, Germany. Electronic address: imhoff@tum.de.
Abstract
PURPOSE: To biomechanically compare the stability of the coracoid process after an anatomic double-tunnel technique using two 4-mm drill holes or a single-tunnel technique using one 4-mm or one 2.4-mm drill hole. METHODS: For biomechanical testing, 18 fresh-frozen cadaveric scapulae were used and randomly assigned to one of the following groups: two 4-mm drill holes (group 1), one 4-mm drill hole (group 2), or one 2.4-mm drill hole (group 3). After standardized coracoid drilling, load was applied to the conjoined tendons at a rate of 120 mm/min and ultimate failure load, along with the failure mode, was recorded. RESULTS: There was no significant difference between groups regarding load to failure. Mean load to failure in group 1 was 392 N; group 2, 459 N; and group 3, 506 N. The corresponding P values were .55, .74, and .20 for group 1 versus group 2, group 2 versus group 3, and group 1 versus group 3, respectively. However, the failure mode for the group with one 4-mm drill hole and the group with two 4-mm drill holes was coracoid fracture, whereas the group with one 2.4-mm drill hole showed 5 tears of the conjoined tendons and only 1 coracoid fracture (P = .015). CONCLUSIONS: Although there was no significant difference regarding load-to-failure testing between groups, the failure mechanism analysis showed that one 2.4-mm drill hole led to less destabilization of the coracoid than one or two 4-mm drill holes. CLINICAL RELEVANCE: Techniques with small, 2.4-mm drill holes might decrease the risk of severe iatrogenic fracture complications.
PURPOSE: To biomechanically compare the stability of the coracoid process after an anatomic double-tunnel technique using two 4-mm drill holes or a single-tunnel technique using one 4-mm or one 2.4-mm drill hole. METHODS: For biomechanical testing, 18 fresh-frozen cadaveric scapulae were used and randomly assigned to one of the following groups: two 4-mm drill holes (group 1), one 4-mm drill hole (group 2), or one 2.4-mm drill hole (group 3). After standardized coracoid drilling, load was applied to the conjoined tendons at a rate of 120 mm/min and ultimate failure load, along with the failure mode, was recorded. RESULTS: There was no significant difference between groups regarding load to failure. Mean load to failure in group 1 was 392 N; group 2, 459 N; and group 3, 506 N. The corresponding P values were .55, .74, and .20 for group 1 versus group 2, group 2 versus group 3, and group 1 versus group 3, respectively. However, the failure mode for the group with one 4-mm drill hole and the group with two 4-mm drill holes was coracoid fracture, whereas the group with one 2.4-mm drill hole showed 5 tears of the conjoined tendons and only 1 coracoid fracture (P = .015). CONCLUSIONS: Although there was no significant difference regarding load-to-failure testing between groups, the failure mechanism analysis showed that one 2.4-mm drill hole led to less destabilization of the coracoid than one or two 4-mm drill holes. CLINICAL RELEVANCE: Techniques with small, 2.4-mm drill holes might decrease the risk of severe iatrogenic fracture complications.
Authors: Farhang Alaee; John Apostolakos; Hardeep Singh; Christian Holwein; Theresa Diermeier; Mark P Cote; Knut Beitzel; Andreas B Imhoff; Augustus D Mazzocca; Andreas Voss Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-02-14 Impact factor: 4.342
Authors: Siva Thangaraju; Serdar Cepni; Petra Magosch; Mark Tauber; Peter Habermeyer; Frank Martetschläger Journal: Knee Surg Sports Traumatol Arthrosc Date: 2019-08-13 Impact factor: 4.342
Authors: Felix Dyrna; Celso Cruz Timm de Oliveira; Michael Nowak; Andreas Voss; Elifho Obopilwe; Sepp Braun; Leo Pauzenberger; Andreas B Imhoff; Augustus D Mazzocca; Knut Beitzel Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-10-06 Impact factor: 4.342
Authors: Felix Dyrna; Daniel P Berthold; Matthias J Feucht; Lukas N Muench; Frank Martetschläger; Andreas B Imhoff; Augustus D Mazzocca; Knut Beitzel Journal: Knee Surg Sports Traumatol Arthrosc Date: 2019-10-17 Impact factor: 4.342