Effect of screw placement on fixation in the humeral head

Liew, Allan; Johnson, James A.; Patterson, Stuart D.; King, Graham J.W.; Chess, David G.

doi:10.1067/mse.2000.107089

Cited by 107 publications

(91 citation statements)

References 8 publications

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“…With the development of anatomic plate designs for joint fractures, different approaches with a high amount of subchondral metalwork are proposed, for example, for the proximal tibia fracture: four small fragment screws with a 3.5-mm diameter or two 4.5-mm locking screws in the less invasive stabilization system (LISS, De Puy Synthes Inc., Brüttisellen, Switzerland). Similar examples exist for distal radius [37] and proximal humerus [15] fractures. Therefore a large volume of the subchondral bone needs to be removed and is replaced by metalwork.…”

Section: Discussionmentioning

confidence: 53%

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Subchondral screw abutment: does it harm the joint cartilage? An in vivo study on sheep tibiae

Goetzen

Hofmann‐Fliri

Arens

et al. 2017

International Orthopaedics (SICOT)

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Purpose Subchondral screw abutment in osteosynthesis of joint fractures is an effective method to achieve sufficient screw grip. In this study we investigated if subchondral screw placement is possible without harming the overlying subchondral plate and joint cartilage iatrogenic. Materials and Methods A 3.5-mm conventional steel screw was placed in the tibia of ten sheep in distances between 1 and 7 mm beneath the joint cartilage. After a follow up of two and four months, evaluation of the subchondral bone and joint cartilage was performed by means of a histological osteoarthritis score, HRpQCT imaging and determination of the glycosaminoglycan content in the cartilage. The control group was the contralateral knee of the same animal. Results Histomorphometric evaluation of the Mankin osteoarthritis score revealed no significant difference compared to the control after two (p = 0.102) and four months (p = 0.429).No correlation between distance of the screw to the cartilage and histological scoring was found (p = 0.658, R2 = 0.04 after two months and p = 0.171, R2 = 0.18 after four months). HRpQCT measurements of the subchondral thickness between screw and cartilage after two (p = 0.05) and four months (p = 0.424) showed no significant difference. Mean glycosaminoglycan content in the treatment group compared to the control after two months (p = 0.25) and four months (p = 0.523) was not significant different. Conclusion In conclusion subchondral screw abutment did not damage the joint cartilage after a two-and four-month follow up in this sheep model.

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Section: Discussionmentioning

confidence: 53%

“…Implant anchorage close to the subchondral plate is an established method to improve the osteosynthesis due to better screw grip in the bone [15,16].…”

Section: Discussionmentioning

confidence: 99%

Subchondral screw abutment: does it harm the joint cartilage? An in vivo study on sheep tibiae

Goetzen

Hofmann‐Fliri

Arens

et al. 2017

International Orthopaedics (SICOT)

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“…A medial support screw inserted obliquely into the medio-inferior region of the humeral head can provide adequate strength to the medial column in locking plating of proximal humerus. A cadaveric biomechanical study by Liew et al found that the grasping force of a screw placed under the subchondral bone of the medial and inferior region was comparably stronger than that of a screw placed either in the middle of the humeral head or in the lateral and superior region [22]. Another histomorphometric study by Hepp et al showed the highest bone strength to be in the medial and dorsal aspects of the proximal humeral head [21].…”

Section: Discussionmentioning

confidence: 99%

The clinical benefit of medial support screws in locking plating of proximal humerus fractures: a prospective randomized study

Zhang

Zheng

Wang

et al. 2011

International Orthopaedics (SICOT)

119

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“…Important aspects of the surgical technique include placement of the plate in strict adherence to the technique, determination of appropriate length and placement of the screws with fluoroscopy, insertion of screws to the head in adequate number and position, providing medial cortex support for the prevention of varus displacement and to fix tubercle fragments, fixation of the sutures passing through the junction of the tubercle and rotator cuff to the plate. [25][26][27] In our study, overall complication rate was 16.32%. The main complications were varus malunion in six patients.…”

Section: Discussionmentioning

confidence: 46%

Study of operative management of proximal humerus fracture treated with locking plates

et al. 2016

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Background: This study was undertaken to evaluate the efficacy of Philos plate and to specifically study the clinical outcome of the patient treated with Philos plate for proximal humerus fracture on the radiological head shaft angle basis.Methods: 40 cases of proximal humerus fracture fixed by using Philos plate were reviewed.Results: Average constant shoulder score as Neer type-3 fracture is 83.8% and for type- 4 part fracture is 86%. Average radiological union was seen at 10.2 weeks. There was no major difference in clinical and radiological union. Conclusions: Good functional outcome with Philos plate irrespective of fracture type was obtained.

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Effect of screw placement on fixation in the humeral head

Cited by 107 publications

References 8 publications

Subchondral screw abutment: does it harm the joint cartilage? An in vivo study on sheep tibiae

Subchondral screw abutment: does it harm the joint cartilage? An in vivo study on sheep tibiae

The clinical benefit of medial support screws in locking plating of proximal humerus fractures: a prospective randomized study

Study of operative management of proximal humerus fracture treated with locking plates

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