Anatomical and Biomechanical Stability of Single/Double Screw‐Cancellous Bone Fixations of Regan–Morry Type III Ulnar Coronoid Fractures in Adults: CT Measurement and Finite Element Analysis
Objective At present, it is still uncertain whether single screw has the same stability as double screws in the treatment of ulnar coronal process basal fracture (Regan–Morry type III). So, we aimed to compare the pull‐out force and anti‐rotation torque of anterior single/double screw‐cancellous bon...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-04-01
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| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.13664 |
| _version_ | 1797847325376249856 |
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| author | Hao Ye Yongchao Yang Tingyang Xing Guirong Tan Shuxun Jin Zhichao Zhao Weikang Zhang Yanyan Li Lei Zhang Jianshun Wang Rongmei Zheng Yun Lu Lijun Wu |
| author_facet | Hao Ye Yongchao Yang Tingyang Xing Guirong Tan Shuxun Jin Zhichao Zhao Weikang Zhang Yanyan Li Lei Zhang Jianshun Wang Rongmei Zheng Yun Lu Lijun Wu |
| author_sort | Hao Ye |
| collection | DOAJ |
| description | Objective At present, it is still uncertain whether single screw has the same stability as double screws in the treatment of ulnar coronal process basal fracture (Regan–Morry type III). So, we aimed to compare the pull‐out force and anti‐rotation torque of anterior single/double screw‐cancellous bone fixation (aSSBF, aDSBF) in this fracture, and further study the influencing factors on anatomical and biomechanical stability of smart screw internal fixations. Methods A total of 63 adult volunteers with no history of elbow injury underwent elbow CT scanning with associated three‐dimensional reconstruction that enabled the measurements of bone density and fixed length of the proximal ulna and coronoid. The models of coronal process basal fracture, aSSBF and aDSBF, were developed and validated. Using the finite element model test, the sensitivity analysis of pull‐out force and rotational torque was carried out. Results The pull‐out force of aSSBF model was positively correlated with the density of the cancellous bone and linearly related to the fixed depth of the screw. The load pattern of pull‐out force of aDSBF model was similar to that of aSSBF model. The ultimate torque of aDSBF model was higher than that of aSSBF model, but the load pattern of ultimate torque of both models was similar to each other when the fracture reset was satisfactory, and the screw nut attaches closely to coronoid process. Moreover, with enhancement of initial pre‐tightening force, the increase of ultimate torque of both models was small. Conclusions In addition to three pull‐out stability factors of smart screw fixations, fracture surface fitting degree and nut fitting degree are the other two important anatomical and biomechanical stability factors of smart screw fixations both for rotational stability. When all pull‐out stability and rotational stability factors meet reasonable conditions simultaneously, single or double screw fixation methods are stable for the treatments of ulnar coronoid basal fractures. |
| first_indexed | 2024-04-09T18:09:27Z |
| format | Article |
| id | doaj.art-d8b55cb1eec849b094953201e32ba93a |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-04-09T18:09:27Z |
| publishDate | 2023-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-d8b55cb1eec849b094953201e32ba93a2023-04-14T04:21:20ZengWileyOrthopaedic Surgery1757-78531757-78612023-04-011541072108410.1111/os.13664Anatomical and Biomechanical Stability of Single/Double Screw‐Cancellous Bone Fixations of Regan–Morry Type III Ulnar Coronoid Fractures in Adults: CT Measurement and Finite Element AnalysisHao Ye0Yongchao Yang1Tingyang Xing2Guirong Tan3Shuxun Jin4Zhichao Zhao5Weikang Zhang6Yanyan Li7Lei Zhang8Jianshun Wang9Rongmei Zheng10Yun Lu11Lijun Wu12Institute of Digitized Medicine and Intelligent Technology Wenzhou Medical University Wenzhou ChinaDepartment of Orthopedics Tianjin Teda Hospital Tianjin ChinaInstitute of Digitized Medicine and Intelligent Technology Wenzhou Medical University Wenzhou ChinaInstitute of Digitized Medicine and Intelligent Technology Wenzhou Medical University Wenzhou ChinaInstitute of Digitized Medicine and Intelligent Technology Wenzhou Medical University Wenzhou ChinaInstitute of Digitized Medicine and Intelligent Technology Wenzhou Medical University Wenzhou ChinaInstitute of Digitized Medicine and Intelligent Technology Wenzhou Medical University Wenzhou ChinaInstitute of Digitized Medicine and Intelligent Technology Wenzhou Medical University Wenzhou ChinaDepartment of Orthopedics, The Third Affiliated Hospital Wenzhou Medical University Wenzhou ChinaDepartment of Orthopedics, The Second Affiliated Hospital Wenzhou Medical University Wenzhou ChinaInstitute of Digitized Medicine and Intelligent Technology Wenzhou Medical University Wenzhou ChinaDepartment of Orthopedics Tianjin Teda Hospital Tianjin ChinaInstitute of Digitized Medicine and Intelligent Technology Wenzhou Medical University Wenzhou ChinaObjective At present, it is still uncertain whether single screw has the same stability as double screws in the treatment of ulnar coronal process basal fracture (Regan–Morry type III). So, we aimed to compare the pull‐out force and anti‐rotation torque of anterior single/double screw‐cancellous bone fixation (aSSBF, aDSBF) in this fracture, and further study the influencing factors on anatomical and biomechanical stability of smart screw internal fixations. Methods A total of 63 adult volunteers with no history of elbow injury underwent elbow CT scanning with associated three‐dimensional reconstruction that enabled the measurements of bone density and fixed length of the proximal ulna and coronoid. The models of coronal process basal fracture, aSSBF and aDSBF, were developed and validated. Using the finite element model test, the sensitivity analysis of pull‐out force and rotational torque was carried out. Results The pull‐out force of aSSBF model was positively correlated with the density of the cancellous bone and linearly related to the fixed depth of the screw. The load pattern of pull‐out force of aDSBF model was similar to that of aSSBF model. The ultimate torque of aDSBF model was higher than that of aSSBF model, but the load pattern of ultimate torque of both models was similar to each other when the fracture reset was satisfactory, and the screw nut attaches closely to coronoid process. Moreover, with enhancement of initial pre‐tightening force, the increase of ultimate torque of both models was small. Conclusions In addition to three pull‐out stability factors of smart screw fixations, fracture surface fitting degree and nut fitting degree are the other two important anatomical and biomechanical stability factors of smart screw fixations both for rotational stability. When all pull‐out stability and rotational stability factors meet reasonable conditions simultaneously, single or double screw fixation methods are stable for the treatments of ulnar coronoid basal fractures.https://doi.org/10.1111/os.13664Anatomical and Biomechanical StabilityDigital Orthopaedics SurgeryFinite Element MethodSmart Screw Internal FixationUlnar Coronoid Fracture |
| spellingShingle | Hao Ye Yongchao Yang Tingyang Xing Guirong Tan Shuxun Jin Zhichao Zhao Weikang Zhang Yanyan Li Lei Zhang Jianshun Wang Rongmei Zheng Yun Lu Lijun Wu Anatomical and Biomechanical Stability of Single/Double Screw‐Cancellous Bone Fixations of Regan–Morry Type III Ulnar Coronoid Fractures in Adults: CT Measurement and Finite Element Analysis Orthopaedic Surgery Anatomical and Biomechanical Stability Digital Orthopaedics Surgery Finite Element Method Smart Screw Internal Fixation Ulnar Coronoid Fracture |
| title | Anatomical and Biomechanical Stability of Single/Double Screw‐Cancellous Bone Fixations of Regan–Morry Type III Ulnar Coronoid Fractures in Adults: CT Measurement and Finite Element Analysis |
| title_full | Anatomical and Biomechanical Stability of Single/Double Screw‐Cancellous Bone Fixations of Regan–Morry Type III Ulnar Coronoid Fractures in Adults: CT Measurement and Finite Element Analysis |
| title_fullStr | Anatomical and Biomechanical Stability of Single/Double Screw‐Cancellous Bone Fixations of Regan–Morry Type III Ulnar Coronoid Fractures in Adults: CT Measurement and Finite Element Analysis |
| title_full_unstemmed | Anatomical and Biomechanical Stability of Single/Double Screw‐Cancellous Bone Fixations of Regan–Morry Type III Ulnar Coronoid Fractures in Adults: CT Measurement and Finite Element Analysis |
| title_short | Anatomical and Biomechanical Stability of Single/Double Screw‐Cancellous Bone Fixations of Regan–Morry Type III Ulnar Coronoid Fractures in Adults: CT Measurement and Finite Element Analysis |
| title_sort | anatomical and biomechanical stability of single double screw cancellous bone fixations of regan morry type iii ulnar coronoid fractures in adults ct measurement and finite element analysis |
| topic | Anatomical and Biomechanical Stability Digital Orthopaedics Surgery Finite Element Method Smart Screw Internal Fixation Ulnar Coronoid Fracture |
| url | https://doi.org/10.1111/os.13664 |
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