Est-il avantageux d’ajouter une vis supplémentaire au travers du calcar dans l’enclouage verrouillé de l’humérus proximal ? - 21/05/15
Is there any advantage in placing an additional calcar screw in locked nailing of proximal humeral fractures?
, M. Schwarze b, L. Bauer a, J. Meyer-Kobbe a, C. Voigt a, C. Hurschler b, H. Lill aAbstract |
Background |
The objective of this study was to evaluate the biomechanical effect of an additional unlocked calcar screw compared to a standard setting with three proximal humeral head screws alone for fixation of an unstable 2-part fracture of the surgical neck.
Hypothesis |
The additional calcar screw improves stiffness and failure load.
Methods |
Fourteen fresh-frozen humeri were randomized into two equal sized groups. An unstable 2-part fracture of the surgical neck was simulated and all specimens were fixed with the MultiLoc®-nail. Group I represented a basic screw setup, with three locked head screws and two unlocked shaft screws. Group II was identical with a supplemental unlocked calcar screw (CS). Stiffness tests were performed in torsional loading, as well as in axial and in 20° abduction/20° adduction modes. Subsequently cyclic loading and load to failure tests were performed. Resulting stiffness, displacement under cyclic load and ultimate load were compared between groups using the t-test for independent variables (α=0.05).
Results |
No significant differences was observed between the groups in any of the biomechanical parameters. Backing out of the CS was observed in three cases.
Discussion |
The use of an additional unlocked calcar screw does not provide mechanical benefit in locked nailing of an unstable 2-part fracture of the surgical neck.
Level of evidence |
Level III. Experimental biomechanical study with human specimen.
Le texte complet de cet article est disponible en PDF.Keywords : Proximal humerus, Fracture, Calcar screw, MultiLoc®, Locked nail
| ☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus. |
Vol 101 - N° 4
P. 275 - juin 2015 Retour au numéro
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