Primary stability of fixation methods for periprosthetic fractures of the humerus: a biomechanical investigation

Ott, Nadine; Harland, Arne; Hackl, Michael; Prescher, Andreas; Leschinger, Tim; Müller, Lars Peter; Wegmann, Kilian

doi:10.1016/j.jse.2020.12.027

Cited by 2 publications

(3 citation statements)

References 27 publications

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“…Secondly, strain gage was used to analyze the construct stability. According to recent studies the use of strain gages for analyzing the stability of the locking plates is an established option [ 10 , 19 , 20 ]. A recently published study by our group has analyzed the primary stability of fixations methods for peri-prosthetic fractures of the humerus using this technique [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…According to recent studies the use of strain gages for analyzing the stability of the locking plates is an established option [ 10 , 19 , 20 ]. A recently published study by our group has analyzed the primary stability of fixations methods for peri-prosthetic fractures of the humerus using this technique [ 10 ]. Also, Stoffel et al showed that bone stability directly correlates with the bending force of a locking plate [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…The measured strain was used as an estimate for construct stability. A comparable system was applied in a previous work of the study group [ 10 ].…”

Section: Methodsmentioning

confidence: 99%

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The effect of long calcar screws on the primary stability of 3-part, varus impacted proximal humeral fractures compared to short calcar screws: a real fracture simulation study

Ott

Hackl

Prescher

et al. 2022

Arch Orthop Trauma Surg

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Background Complex proximal humeral fracture ranks among the most common fracture types, especially in elderly patients. In locked plate fixation of proximal humerus fractures, the calcar is deciding for screws providing further medial column support. To date, the biomechanical effect of the length of these calcar screws is not well known. The purpose of this study was to analyze the effect of long calcar screws on fresh frozen prefractured cadaveric specimens. Methods In the present biomechanical study, 8 pairs of cadaveric proximal humeri were fractured identically using a custom-made fracture simulator. ORIF was performed using a locking plate (PHILOS; Fa. Synthes). The specimens were tested in a biomechanical setup under increased axial load without any calcar screws installed, with short calcar screws and long calcar screws installed. Strain gages (4-wire-120 Ohm, Fa. Vishay) mounted on the locking plate were used to evaluate the fixation strain and to give an estimate for primary stability.. Results The measured strain of the locking plate without calcar screws (804,64 µm/m) at maximum load (200 N) was significantly higher than with short (619,07 µm/m; p = 0.02) or long calcar screws (527,31 µm/m; p = 0.007). Additionally, strain with short calcar screws was noticeably higher in comparison to long calcar screws (619,07 µm/m vs. 527,31 µm/m; p = 0.03). Conclusion Use of calcar screws improves the stability of realistically impacted 3-part varus humeral fractures. Long calcar screws that are positioned as close as possible to the joint provide further primary stability compared to short calcar screws. Level of evidence Basic science study.

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