Augmented cerclage wire improves the fixation strength of a two-screw construct for humerus split type greater tuberosity fracture: a biomechanical study
Abstract Background Poor functional outcome can result from humeral greater tuberosity (GT) fracture if not treated appropriately. A two-screw construct is commonly used for the surgical treatment of such injury. However, loss of reduction is still a major concern after surgery. To improve the biome...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-04-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-021-04215-7 |
| _version_ | 1818950318123122688 |
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| author | Chao-Jui Chang Wei-Ren Su Kai-Lan Hsu Chih-Kai Hong Fa-Chuan Kuan Chih-Hsun Chang Cheng-Li Lin |
| author_facet | Chao-Jui Chang Wei-Ren Su Kai-Lan Hsu Chih-Kai Hong Fa-Chuan Kuan Chih-Hsun Chang Cheng-Li Lin |
| author_sort | Chao-Jui Chang |
| collection | DOAJ |
| description | Abstract Background Poor functional outcome can result from humeral greater tuberosity (GT) fracture if not treated appropriately. A two-screw construct is commonly used for the surgical treatment of such injury. However, loss of reduction is still a major concern after surgery. To improve the biomechanical strength of screw fixation in GT fractures, we made a simple modification of the two-screw construct by adding a cerclage wire to the two-screw construct. The purpose of this biomechanical study was to analyze the effect of this modification for the fixation of GT fractures. Materials and methods Sixteen fresh-frozen human cadaveric shoulders were used in this study. The fracture models were arbitrarily assigned to one of two fixation methods. Group A (n = 8) was fixed with two threaded cancellous screws with washers. In group B (n = 8), all screws were set using methods identical to group A, with the addition of a cerclage wire. Horizontal traction was applied via a stainless steel cable fixed directly to the myotendinous junction of the supraspinatus muscle. Displacement of the fracture fixation under a pulling force of 100 N/200 N and loading force to construct failure were measured. Results The mean displacements under 100 N and 200 N traction force were both significantly decreased in group B than in group A. (100 N: 1.06 ± 0.12 mm vs. 2.26 ± 0.24 mm, p < 0.001; 200 N: 2.21 ± 0.25 mm vs. 4.94 ± 0.30 mm, p < 0.001) Moreover, the failure load was significantly higher in group B compared with group A. (415 ± 52 N vs.335 ± 47 N, p = 0.01), Conclusions The current biomechanical cadaveric study demonstrated that the two-screw fixation construct augmented with a cerclage wire has higher mechanical performance than the conventional two-screw configuration for the fixation of humeral GT fractures. Trial registration Retrospectively registered. |
| first_indexed | 2024-12-20T09:16:41Z |
| format | Article |
| id | doaj.art-7b317c42cb52420284dc9d224c70bd72 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-20T09:16:41Z |
| publishDate | 2021-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-7b317c42cb52420284dc9d224c70bd722022-12-21T19:45:24ZengBMCBMC Musculoskeletal Disorders1471-24742021-04-012211810.1186/s12891-021-04215-7Augmented cerclage wire improves the fixation strength of a two-screw construct for humerus split type greater tuberosity fracture: a biomechanical studyChao-Jui Chang0Wei-Ren Su1Kai-Lan Hsu2Chih-Kai Hong3Fa-Chuan Kuan4Chih-Hsun Chang5Cheng-Li Lin6Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityDepartment of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityDepartment of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityDepartment of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityDepartment of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityDepartment of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityDepartment of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityAbstract Background Poor functional outcome can result from humeral greater tuberosity (GT) fracture if not treated appropriately. A two-screw construct is commonly used for the surgical treatment of such injury. However, loss of reduction is still a major concern after surgery. To improve the biomechanical strength of screw fixation in GT fractures, we made a simple modification of the two-screw construct by adding a cerclage wire to the two-screw construct. The purpose of this biomechanical study was to analyze the effect of this modification for the fixation of GT fractures. Materials and methods Sixteen fresh-frozen human cadaveric shoulders were used in this study. The fracture models were arbitrarily assigned to one of two fixation methods. Group A (n = 8) was fixed with two threaded cancellous screws with washers. In group B (n = 8), all screws were set using methods identical to group A, with the addition of a cerclage wire. Horizontal traction was applied via a stainless steel cable fixed directly to the myotendinous junction of the supraspinatus muscle. Displacement of the fracture fixation under a pulling force of 100 N/200 N and loading force to construct failure were measured. Results The mean displacements under 100 N and 200 N traction force were both significantly decreased in group B than in group A. (100 N: 1.06 ± 0.12 mm vs. 2.26 ± 0.24 mm, p < 0.001; 200 N: 2.21 ± 0.25 mm vs. 4.94 ± 0.30 mm, p < 0.001) Moreover, the failure load was significantly higher in group B compared with group A. (415 ± 52 N vs.335 ± 47 N, p = 0.01), Conclusions The current biomechanical cadaveric study demonstrated that the two-screw fixation construct augmented with a cerclage wire has higher mechanical performance than the conventional two-screw configuration for the fixation of humeral GT fractures. Trial registration Retrospectively registered.https://doi.org/10.1186/s12891-021-04215-7Humeral greater tuberosity fractureCerclage wireScrew fixationBiomechanicsCadaver |
| spellingShingle | Chao-Jui Chang Wei-Ren Su Kai-Lan Hsu Chih-Kai Hong Fa-Chuan Kuan Chih-Hsun Chang Cheng-Li Lin Augmented cerclage wire improves the fixation strength of a two-screw construct for humerus split type greater tuberosity fracture: a biomechanical study BMC Musculoskeletal Disorders Humeral greater tuberosity fracture Cerclage wire Screw fixation Biomechanics Cadaver |
| title | Augmented cerclage wire improves the fixation strength of a two-screw construct for humerus split type greater tuberosity fracture: a biomechanical study |
| title_full | Augmented cerclage wire improves the fixation strength of a two-screw construct for humerus split type greater tuberosity fracture: a biomechanical study |
| title_fullStr | Augmented cerclage wire improves the fixation strength of a two-screw construct for humerus split type greater tuberosity fracture: a biomechanical study |
| title_full_unstemmed | Augmented cerclage wire improves the fixation strength of a two-screw construct for humerus split type greater tuberosity fracture: a biomechanical study |
| title_short | Augmented cerclage wire improves the fixation strength of a two-screw construct for humerus split type greater tuberosity fracture: a biomechanical study |
| title_sort | augmented cerclage wire improves the fixation strength of a two screw construct for humerus split type greater tuberosity fracture a biomechanical study |
| topic | Humeral greater tuberosity fracture Cerclage wire Screw fixation Biomechanics Cadaver |
| url | https://doi.org/10.1186/s12891-021-04215-7 |
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