Universität zu Köln

Ott, Nadine, Hackl, Michael ORCID: 0000-0002-6183-5621, Prescher, Andreas, Scaal, Martin, Lanzerath, Fabian, Muller, Lars Peter and Wegmann, Kilian (2023). The effect of long calcar screws on the primary stability of 3-part, varus impacted proximal humeral fractures compared to short calcar screws: a real fracture simulation study. Arch. Orthop. Trauma Surg., 143 (5). S. 2485 - 2492. NEW YORK: SPRINGER. ISSN 1434-3916

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Abstract

Background Complex proximal humeral fracture ranks among the most common fracture types, especially in elderly patients. In locked plate fixation of proximal humerus fractures, the calcar is deciding for screws providing further medial column support. To date, the biomechanical effect of the length of these calcar screws is not well known. The purpose of this study was to analyze the effect of long calcar screws on fresh frozen prefractured cadaveric specimens. Methods In the present biomechanical study, 8 pairs of cadaveric proximal humeri were fractured identically using a custom-made fracture simulator. ORIF was performed using a locking plate (PHILOS; Fa. Synthes). The specimens were tested in a biomechanical setup under increased axial load without any calcar screws installed, with short calcar screws and long calcar screws installed. Strain gages (4-wire-120 Ohm, Fa. Vishay) mounted on the locking plate were used to evaluate the fixation strain and to give an estimate for primary stability.. Results The measured strain of the locking plate without calcar screws (804,64 mu m/m) at maximum load (200 N) was significantly higher than with short (619,07 mu m/m; p = 0.02) or long calcar screws (527,31 mu m/m; p = 0.007). Additionally, strain with short calcar screws was noticeably higher in comparison to long calcar screws (619,07 mu m/m vs. 527,31 mu m/m; p = 0.03). Conclusion Use of calcar screws improves the stability of realistically impacted 3-part varus humeral fractures. Long calcar screws that are positioned as close as possible to the joint provide further primary stability compared to short calcar screws.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ott, Nadine UNSPECIFIED UNSPECIFIED UNSPECIFIED Hackl, Michael UNSPECIFIED orcid.org/0000-0002-6183-5621 UNSPECIFIED Prescher, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Scaal, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Lanzerath, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Muller, Lars Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegmann, Kilian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-669545
DOI:	10.1007/s00402-022-04473-7
Journal or Publication Title:	Arch. Orthop. Trauma Surg.
Volume:	143
Number:	5
Page Range:	S. 2485 - 2492
Date:	2023
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1434-3916
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LOCKING PLATE FIXATION; SUPPORT; VIVO; LOAD; GAP Multiple languages Orthopedics; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66954