Biomechanical analysis of intramedullary vs. superior plate fixation of transverse midshaft clavicle fractures

Journal of Shoulder and Elbow Surgery
David J WilsonEdward D Arrington

Abstract

Middle-third clavicle fractures represent 2% to 4% of all skeletal trauma in the United States. Treatment options include intramedullary (IM) as well as plate and screw (PS) constructs. The purpose of this study was to analyze the biomechanical stability of a specific IM system compared with nonlocking PS fixation under low-threshold physiologic load. Twenty fourth-generation Sawbones (Pacific Research Laboratories, Vashon, WA, USA) with a simulated middle-third fracture pattern were repaired with either an IM device (n = 10) or superiorly positioned nonlocking PS construct (n = 10). Loads were modeled to simulate physiologic load. Combined axial compression and torsion forces were sequentially increased until failure. Data were analyzed on the basis of loss of rotational stability using 3 criteria: early (10°), clinical (30°), and terminal (120°). No significant difference was noted between constructs in early loss of rotational stability (P > .05). The PS group was significantly more rotationally stable than the IM group on the basis of clinical and terminal criteria (P < .05 for both). All test constructs failed in rotational stability. When tested under physiologic load, fixation failure occurred from loss of rotational sta...Continue Reading

References

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Citations

Sep 5, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Brent WieselRyan Churchill
Apr 20, 2017·BMC Musculoskeletal Disorders·Jie AiShi-Qing Feng
Apr 28, 2019·BMC Musculoskeletal Disorders·Sheng-Hao WangJui-Jung Yang
Jul 9, 2020·Expert Review of Medical Devices·Paul Reginald King, Robert Patrick Lamberts
Nov 30, 2018·Der Unfallchirurg·M WurmC Kirchhoff
Feb 12, 2021·Journal of Shoulder and Elbow Surgery·Joseph J RuzbarskyThomas R Hackett
Jul 23, 2021·Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine·Bryce F KunkleStephen A Parada

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