A guideline for screw fixation of coracoid process base fracture by 3D simulation
Abstract Background Fractures of the base of the coracoid process are relatively rare, but an increasing number of studies have reported using screws to fix coracoid process base fractures. This study was performed to simulate the surgical procedure and obtain the ideal diameter, length, insertion p...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-01-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-021-02203-0 |
| _version_ | 1797999240740339712 |
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| author | Zhongye Sun Hao Li Bei Wang Jun Yan Liren Han Shizhang Han Xiaofei Yang Bei Zhao |
| author_facet | Zhongye Sun Hao Li Bei Wang Jun Yan Liren Han Shizhang Han Xiaofei Yang Bei Zhao |
| author_sort | Zhongye Sun |
| collection | DOAJ |
| description | Abstract Background Fractures of the base of the coracoid process are relatively rare, but an increasing number of studies have reported using screws to fix coracoid process base fractures. This study was performed to simulate the surgical procedure and obtain the ideal diameter, length, insertion point and angle of the screw from a 3-D axial perspective in Chinese patients. Methods We randomly collected right scapula computed tomography (CT) scans from 100 adults. DICOM-formatted CT scan images were imported into Mimics software. A 3D digital model of the right scapula was established. Two virtual cylinders representing two screws were placed from the top of the coracoid process to the neck of the scapula and across the base of the coracoid process to fix the base of the coracoid process. The largest secure diameters and lengths of the virtual screws were measured. The positions of the insertion points and the directions of the screws were also examined. Results The screw insertion safe zone can exhibit an irregular fusiform shape according to the reconstructed scapula model. The mean maximum diameters of the medial and lateral screws were 7.08 ± 1.19 mm and 7.34 ± 1.11 mm, respectively. The mean maximum lengths of the medial and lateral screws were 43.11 ± 6.31 mm and 48.16 ± 6.94 mm, respectively. A screw insertion corridor with a diameter of at least 4.5 mm was found in all patients. We found sex-dependent differences in the mean maximum diameters and maximum lengths of the two screws. The positions of the two insertion points were statistically different across sexes. Conclusions The study provides a valuable guideline for determining the largest secure corridor for two screws in fixing a fracture at the base of the coracoid process. For ideal screw placement, we suggest individualised preoperative 3D reconstruction simulations. Further biomechanical studies are needed to verify the function of the screws. |
| first_indexed | 2024-04-11T11:01:32Z |
| format | Article |
| id | doaj.art-10345161f0e44ea4b1905ffbd1a0ca27 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T11:01:32Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-10345161f0e44ea4b1905ffbd1a0ca272022-12-22T04:28:36ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-01-011611810.1186/s13018-021-02203-0A guideline for screw fixation of coracoid process base fracture by 3D simulationZhongye Sun0Hao Li1Bei Wang2Jun Yan3Liren Han4Shizhang Han5Xiaofei Yang6Bei Zhao7Department of Orthopaedics, Liaocheng People’s HospitalDepartment of Orthopaedics, Liaocheng People’s HospitalDepartment of Imaging, Liaocheng Infectious Disease HospitalDepartment of Orthopaedics, Liaocheng People’s HospitalDepartment of Orthopaedics, Liaocheng People’s HospitalDepartment of Orthopaedics, Liaocheng People’s HospitalDepartment of Orthopaedics, Liaocheng People’s HospitalDepartment of Orthopaedics, Liaocheng People’s HospitalAbstract Background Fractures of the base of the coracoid process are relatively rare, but an increasing number of studies have reported using screws to fix coracoid process base fractures. This study was performed to simulate the surgical procedure and obtain the ideal diameter, length, insertion point and angle of the screw from a 3-D axial perspective in Chinese patients. Methods We randomly collected right scapula computed tomography (CT) scans from 100 adults. DICOM-formatted CT scan images were imported into Mimics software. A 3D digital model of the right scapula was established. Two virtual cylinders representing two screws were placed from the top of the coracoid process to the neck of the scapula and across the base of the coracoid process to fix the base of the coracoid process. The largest secure diameters and lengths of the virtual screws were measured. The positions of the insertion points and the directions of the screws were also examined. Results The screw insertion safe zone can exhibit an irregular fusiform shape according to the reconstructed scapula model. The mean maximum diameters of the medial and lateral screws were 7.08 ± 1.19 mm and 7.34 ± 1.11 mm, respectively. The mean maximum lengths of the medial and lateral screws were 43.11 ± 6.31 mm and 48.16 ± 6.94 mm, respectively. A screw insertion corridor with a diameter of at least 4.5 mm was found in all patients. We found sex-dependent differences in the mean maximum diameters and maximum lengths of the two screws. The positions of the two insertion points were statistically different across sexes. Conclusions The study provides a valuable guideline for determining the largest secure corridor for two screws in fixing a fracture at the base of the coracoid process. For ideal screw placement, we suggest individualised preoperative 3D reconstruction simulations. Further biomechanical studies are needed to verify the function of the screws.https://doi.org/10.1186/s13018-021-02203-0Coracoid process baseAxial perspectiveDigital measurementScrew fixation |
| spellingShingle | Zhongye Sun Hao Li Bei Wang Jun Yan Liren Han Shizhang Han Xiaofei Yang Bei Zhao A guideline for screw fixation of coracoid process base fracture by 3D simulation Journal of Orthopaedic Surgery and Research Coracoid process base Axial perspective Digital measurement Screw fixation |
| title | A guideline for screw fixation of coracoid process base fracture by 3D simulation |
| title_full | A guideline for screw fixation of coracoid process base fracture by 3D simulation |
| title_fullStr | A guideline for screw fixation of coracoid process base fracture by 3D simulation |
| title_full_unstemmed | A guideline for screw fixation of coracoid process base fracture by 3D simulation |
| title_short | A guideline for screw fixation of coracoid process base fracture by 3D simulation |
| title_sort | guideline for screw fixation of coracoid process base fracture by 3d simulation |
| topic | Coracoid process base Axial perspective Digital measurement Screw fixation |
| url | https://doi.org/10.1186/s13018-021-02203-0 |
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