Comparison of crossed screw versus plate fixation for radial neck fractures

Gutowski, Christina J.; Darvish, Kurosh; Ilyas, Asif M.; Jones, Christopher M.

doi:10.1016/j.clinbiomech.2015.07.001

Cited by 18 publications

(22 citation statements)

References 13 publications

(15 reference statements)

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“…New techniques and implants have been developed for the maintenance of radial head fractures. However, only a few biomechanical studies have examined Mason type II radial head fractures to date [ 17 – 22 ]. Klaus et al [ 17 ] evaluated the 3.0-mm headless compression screw and the standard 2.0-mm cortical screw used for fixation of radial head fractures.…”

Section: Discussionmentioning

confidence: 99%

“…No significant differences concerning the stability achieved by the 3.0-mm headless compression screw, and the 2.0-mm cortical screw could be detected in the experimental setup presented. In a recent article, Christina et al [ 22 ] compared the mechanical properties of crossed screw and plate fixation in the model of a radial neck fracture; the two strategies provided similar strength and stiffness for the fixation of transverse, non-comminuted radial neck fractures.…”

Section: Discussionmentioning

confidence: 99%

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Effect of different orientations of screw fixation for radial head fractures: a biomechanical comparison

Shi

Pan

et al. 2017

J Orthop Surg Res

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BackgroundScrew fixation is a common method used for the treatment of Mason type II radial head fractures. The purpose of our study was to evaluate the mechanical properties of three different screw orientations used for fixation of Mason type II radial head fractures.MethodsWe sawed 24 medium-frequency fourth-generation Synbone radial bones to simulate unstable radial head fractures, which we then fixed with three different screw orientations. Implants were tested under axial load by the tension-torsion composite test system. If the implant-radial constructs did not fail after the axial load test, an axial failure load was added to the remaining constructs.ResultsThe stiffness of the divergent group was the highest of the three orientations, and this group had statistically significant difference from the other two groups (p < 0.05). However, there was no statistically significant difference between the convergence group and the parallel group (p > 0.05). When the displacement reached 2 mm, the load of the divergent screw was still larger than the other two groups (p < 0.05).ConclusionsThe divergent screw orientation was the most stable and had the greatest control of Mason type II fractures of these three groups. Therefore, it can be better applied in clinical settings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effect of different orientations of screw fixation for radial head fractures: a biomechanical comparison

Shi

Pan

et al. 2017

J Orthop Surg Res

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“…To date, few biomechanical studies have been conducted on radial head and neck fractures. 14,[20][21][22][23][24][25] Only two studies are available on the subject of radial head fractures. Koslowski et al 22 performed a biomechanical comparison of four different fixation methods on a Mason type III sawbone fracture model.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical dynamic comparison of biodegradable pins and titanium screws for operative stabilization of displaced radial head fractures

Wagner

Feucht

Konstantinidis

et al. 2019

Proc Inst Mech Eng H

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For radial head osteosynthesis, biodegradable implants are gaining in importance to minimize cartilage destruction and implant impingement and to supersede implant removal. Since loss of reduction and pseudarthrosis remain challenging complications, new implants should at least provide comparable biomechanical properties as commonly used metal implants. The objective of this study was to compare the treatment by polylactide pins to titanium screws and to quantify the produced cartilage defects. Eight pairs of human cadaver radii with a standardized Mason type II fracture were stabilized either by two 2.0-mm polylactide pins or titanium screws. The produced cartilage defects were quantified using an image analyzing software. Quasi-static loading was performed axially and transversally for 10 cycles each between 10 and 50 N. Afterward, implant loosening was tested by axial loading up to 10,000 cycles, followed by load to failure testing. Polylactide pins showed less construct stiffness under axial (p = 0.017) and transversal (p = 0.012) loading, and one polylactide pins construct failed after two cycles of transversal loading. At axial loading, a high correlation between bone mineral density and construct stiffness was observed among polylactide pins (R = 0.667; p = 0.071), which was not seen among titanium screws (R = 0.262; p = 0.531). No difference in implant loosening was recorded after 10,000 cycles (p = 0.237); however, one polylactide pins construct failed after 30 cycles and failure loads were higher for titanium screws (p=0.017). Polylactide pin produced smaller cartilage defects (p=0.012). In conclusion, simple radial head fractures treated by polylactide pins show less biomechanical stability than treated by titanium screws, particularly in osteoporotic bone which might lead to secondary loss of reduction. Due to smaller cartilage defects and equal properties under continuous loading, polylactide pins might represent a gentle alternative in patients with good bone quality making subsequent implant removal redundant.

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“…The length of the two screws was uniform, and the distance between the two screws was 5 mm. The plate was placed in the safe zone of the radial head, which lies on the dorsal surface of the radius [ 18 ]. The fixations were evaluated using X-ray images.…”

Section: Methodsmentioning

confidence: 99%

Comparison of three different fixation constructs for radial neck fractures: a biomechanical study

Chen¹,

Pan

et al. 2017

J Orthop Surg Res

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BackgroundFixation of radial neck fractures can be achieved with a plate and screw construct or with two screws. This study evaluated the biomechanical properties of three different fixation methods following radial neck fractures.MethodsTwenty-four fourth-generation composite radii were sawed to simulate an unstable radial neck fracture. They were then instrumented with a plate and screw construct or two different orientations (crossed and parallel) of screw fixation. Implants were tested under bending and torsional loads via a tension torsion composite test system. Bending and torsional failure loads were added to the remaining implant-radius constructs if they did not fail during the previous tests.ResultsDuring the bending loading test, the crossed-screw group showed the greatest stiffness, followed by the parallel-screw group, the plate group demonstrating the weakest stiffness. There was no significant difference between the crossed- and the parallel-screw groups. However, there was a significant difference between the two screw groups and the plate group. During the bending failure test, the largest stiffness was found for the crossed-screw group, while the plate group exhibited the smallest stiffness. There was a significant difference between the three groups. During the torsion loading test, the highest stiffness was observed for the crossed-screw group, while the plate group showed the lowest stiffness. In the torsion failure test, the failure torques were 11.97 ± 2.659, 8.531 ± 1.768, and 7.079 ± 1.666 N m respectively for the crossed-screw, parallel-screw, and plate groups. There was a significant difference between the crossed-screw group and the two other groups.ConclusionsCrossed screws and plate fixation are commonly used in clinical practice to treat simple radial neck fractures. While the present study shows that the parallel-screw method results in similar biomechanical strength as the two other techniques, it has the advantages of reaching limited wound exposure and having the implant buried. Therefore, it may be widely used in clinical practice.

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Comparison of crossed screw versus plate fixation for radial neck fractures

Cited by 18 publications

References 13 publications

Effect of different orientations of screw fixation for radial head fractures: a biomechanical comparison

Effect of different orientations of screw fixation for radial head fractures: a biomechanical comparison

Biomechanical dynamic comparison of biodegradable pins and titanium screws for operative stabilization of displaced radial head fractures

Comparison of three different fixation constructs for radial neck fractures: a biomechanical study

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