Biomechanical Assessment of Three Osteosynthesis Constructs by Periprosthetic Humerus Fractures

Background. Biomechanical stability assessment of 3 different constructs for proximal fixation of a locking compression plate (LCP) in treating a Worland type C periprosthetic fracture after total shoulder arthroplasty. Methods. 27 Worland type C fractures after shoulder arthroplasty in synthetic hu...

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Bibliographic Details
Main Authors: Afif Harb, Bastian Welke, Emmanouil Liodakis, Sam Razaeian, Dafang Zhang, Christian Krettek, Christof Hurschler, Nael Hawi
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Advances in Orthopedics
Online Access:http://dx.doi.org/10.1155/2020/8872419
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Summary:Background. Biomechanical stability assessment of 3 different constructs for proximal fixation of a locking compression plate (LCP) in treating a Worland type C periprosthetic fracture after total shoulder arthroplasty. Methods. 27 Worland type C fractures after shoulder arthroplasty in synthetic humeri were treated with 14-hole LCP that is proximally fixed using the following: (1) 1 × 1.5 mm cerclage wires and 2x unicortical-locking screws, (2) 3 × 1.5 mm cerclage wires, or (3) 2x bicortical-locking attachment plates. Torsional stiffness was assessed by applying an internal rotation moment of 5 Nm and then after unloading the specimen, an external rotation moment of 5 Nm at the same rate was applied. Axial stiffness was assessed by applying a 50 N preload, and then applying a cyclic load of 250 N, then increasing the load by 50 N each time, until a maximum axial load of 2500 N was reached or specimen failure occurred. Results. With regard to internal as well as external rotational stiffness, group 1 showed a mean stiffness of 0.37 Nm/deg and 0.57 Nm/deg, respectively, group 2 had a mean stiffness of 0.51 Nm/deg and 0.39 Nm/deg, respectively, while group 3 had a mean stiffness of 1.34 Nm/deg and 1.31 Nm/deg, respectively. Concerning axial stiffness, group 1 showed an average stiffness of 451.0 N/mm, group 2 had a mean stiffness of 737.5 N/mm, whereas group 3 had a mean stiffness of 715.8 N/mm. Conclusion. Group 3 displayed a significantly higher torsional stiffness while a comparable axial stiffness to group 2.
ISSN:2090-3464
2090-3472