A biomechanical comparison of new techniques for distal clavicular fracture repair versus locked plating.
J Shoulder Elbow Surg
; 28(5): 982-988, 2019 May.
Article
en En
| MEDLINE
| ID: mdl-30713066
ABSTRACT
BACKGROUND:
Unstable distal clavicular fractures treated surgically are associated with high failure rates and hardware-related complications. Newer techniques have shown promising early clinical results with fewer hardware complications; however, their biomechanical performance has not been assessed. This study biomechanically compared a distal-third locking plate with 3 newer techniques that incorporate coracoid fixation into the construct.METHODS:
The study randomized 36 adult fresh frozen cadaveric shoulders to 4 groups (1) distal-third locking plate (P); (2) distal-third locking plate with a coracoid button augmentation (P + CB); (3) coracoclavicular button (CB); and (4) coracoclavicular button with coracoclavicular ligament reconstruction using semitendinosus allograft (CB + CC). After fixation, each specimen was stressed in the coronal plane. Cyclic displacement, load at 10-mm displacement, and ultimate load to failure were measured.RESULTS:
All 3 experimental groups biomechanically outperformed the locking plate. Mean load to failure was significantly higher in the CB (343 ± 76 N) and CB + CC (349 ± 94 N) groups compared with the P group (193 ± 52 N). There was also significantly less cyclic displacement in the CB (4.3 ± 1.9 mm) and CB + CC (4.4 ± 1.9 mm) groups compared with the P group (8.2 ± 2.9 mm). With respect to load at 10 mm of displacement, which essentially measures a clinical failure, the P + CB (235 ± 112 N), CB (253 ± 111 N), and CB+CC (238 ± 76 N) experimental groups significantly outperformed the P group (96 ± 29 N).CONCLUSIONS:
CB and CB + CC techniques demonstrated more than 75% greater strength than the traditional locking plate alone. Coupled with greater overall construct strength and lower-profile hardware, these newer techniques may result in improved clinical outcome and fewer hardware-related complications.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Placas Óseas
/
Clavícula
/
Fracturas Óseas
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Fijación Interna de Fracturas
Tipo de estudio:
Clinical_trials
Límite:
Adult
/
Aged
/
Aged80
/
Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Shoulder Elbow Surg
Asunto de la revista:
ORTOPEDIA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Estados Unidos