The position and number of screws influence screw perforation of the humeral head in modern locking plates: a cadaver study

Journal of Orthopaedic Trauma
Johannes B ErhardtM S Kuster

Abstract

Screw perforation of the humeral head in locking plate osteosynthesis occurs in up to 30% of cases. The current study compared different fixation possibilities (eg, number and position of screws) to reduce screw perforation in the humeral head. A humeral head fracture with a missing medial support was created in 30 fresh-frozen cadavers and fixed with a polyaxial locking plate (NCB PH; Zimmer, Warsaw, IN). The constructs were loaded with increasing force and the number of cycles until screw perforation was recorded. Four different fixation methods were tested: group 1 five screws with fixed angle, group 2 five screws in polyaxial position according to bone strength, group 3 three screws, and group 4 five screws with 1 as an inferomedial support screw. More screws in the humeral head significantly increased the number of cycles before screw perforation. An inferomedial support screw further increased the number of cycles. Polyaxial screw placement compared with fixed-angle placement had no effect on the screw perforation phenomenon. We recommend to position an inferomedial support screw, and at least 5 screws in the head fragment, when using a locking plate in proximal humerus fractures with disrupted medial hinge.

References

May 9, 2001·The Journal of Bone and Joint Surgery. British Volume·K B FreedmanJ Bernstein
Jun 14, 2002·The Journal of Bone and Joint Surgery. American Volume·Brian K KwonThomas R Oxland
Nov 13, 2003·Clinical Orthopaedics and Related Research·Pierre HeppGeorg N Duda
Sep 5, 2006·The Journal of Bone and Joint Surgery. American Volume·Michael J GardnerDean G Lorich
Oct 4, 2006·The Journal of Bone and Joint Surgery. American Volume·Sara L EdwardsBradley R Merk
Dec 23, 2006·Archives of Orthopaedic and Trauma Surgery·C P CharalambousH Marynissen
May 3, 2007·Journal of Orthopaedic Trauma·Michael J GardnerDean G Lorich
Jun 30, 2009·Archives of Orthopaedic and Trauma Surgery·Johannes B ErhardtM S Kuster

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Citations

Jan 17, 2013·Current Reviews in Musculoskeletal Medicine·Marschall B BerkesDean G Lorich
Jul 15, 2015·Journal of Orthopaedic Trauma·Erik McDonaldUtku Kandemir
Apr 30, 2015·Orthopaedics & Traumatology, Surgery & Research : OTSR·J C KatthagenH Lill
Feb 1, 2019·Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine·Ali JabranLei Ren
Jul 28, 2019·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Daniel CiricPeter Varga
Sep 28, 2017·Journal of Orthopaedic Surgery and Research·Christoph J LauxGeorg Osterhoff
Jul 27, 2018·BMC Musculoskeletal Disorders·Ali JabranLei Ren
Dec 25, 2013·Revista Brasileira De Ortopedia·Mauro Emilio Conforto GracitelliJorge Dos Santos Silva
Aug 9, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Klaus W WendtRadko Komadina
Dec 9, 2020·Journal of Biomechanics·Luca CristofoliniEnrico Guerra
Dec 22, 2020·JSES International·Martin BoulianeUNKNOWN Shoulder and Upper Extremity Research Group of Edmonton (SURGE)
Feb 2, 2021·Journal of the Mechanical Behavior of Biomedical Materials·Vasiliki C PanagiotopoulouPeter Varga
Feb 25, 2021·Geriatric Orthopaedic Surgery & Rehabilitation·Hyojune KimKyoung Hwan Koh

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