Primary stability of nailing versus low-profile dual plating of mid-clavicular fractures- a biomechanical cadaveric study.

IF 2.2 3区 医学 Q2 EMERGENCY MEDICINE
Fabian Pretz, Ivan Zderic, Frank J P Beeres, Björn-Christian Link, Reto Babst, Yannic Lecoultre, Boyko Gueorguiev, Peter Varga, Torsten Pastor, Bryan J M van de Wall
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引用次数: 0

Abstract

Introduction: Low-profile dual plating techniques have gained popularity for diaphyseal clavicula fractures due to their potential to reduce soft tissue irritation. Intramedullary nailing is also an established surgical option for treatment of diaphyseal clavicle fractures. The present study therefore aimed to evaluate whether a 2 × 2.0 mm dual plating system can achieve biomechanical performance comparable to intramedullary nailing while reducing implant-related complications.

Methodology: Twelve paired human cadaveric clavicles with simulated unstable diaphyseal shaft fractures AO/OTA 15.2 C were stabilized via elastic nailing (Group 1) or dual plating using a superior and an anterior 2.0 mm plate (Group 2). Specimens underwent biomechanical testing with initial quasistatic superior-inferior and anterior-posterior bending, followed by cyclic superior-inferior loading to failure. Interfragmentary movements were monitored by optical motion tracking.

Results: Dual plating demonstrated significantly higher initial construct stiffness in all bending directions and a reduced neutral zone compared to intramedullary nailing (p ≤ 0.016). In addition, fracture displacement amplitudes over all cycles were significantly higher in Group 1 versus Group 2 (p = 0.002). The number of cycles required to reach the test endpoint at a 45 mm displacement did not differ significantly between the groups (p = 0.160), with Group 1 averaging 24,420 cycles (SD ± 3,615) and Group 2 averaging 28,232 cycles (SD ± 5,417).

Conclusion: Low-profile dual plating may offer improved initial stability of midshaft clavicle fractures without compromising their long-term performance, making it a promising alternative to elastic nailing. In selected patients with simpler unstable midshaft clavicle fractures, 2 × 2.0 mm dual plating may offer effective biomechanical stability.

Abstract Image

Abstract Image

Abstract Image

锁骨中部骨折内钉与低轮廓双钢板的初步稳定性-一项生物力学尸体研究。
简介:由于具有减少软组织刺激的潜力,低轮廓双钢板技术在骨干锁骨骨折中越来越受欢迎。髓内钉也是治疗骨干锁骨骨折的一种成熟的手术选择。因此,本研究旨在评估2 × 2.0 mm双电镀系统是否能达到与髓内钉相当的生物力学性能,同时减少种植体相关并发症。方法:12对模拟不稳定骨干骨折AO/OTA 15.2 C的人尸体锁骨通过弹性钉固定(1组)或使用上、前2.0 mm钢板双钢板固定(2组)。通过初始准静态上下弯曲和前后弯曲进行生物力学测试,然后循环上下加载至破坏。通过光学运动跟踪监测碎片间运动。结果:与髓内钉相比,双钢板在所有弯曲方向上表现出更高的初始构造刚度和减少的中性区(p≤0.016)。此外,在所有周期中,1组的骨折位移幅度明显高于2组(p = 0.002)。在45 mm位移处达到测试终点所需的周期数在两组之间没有显着差异(p = 0.160),组1平均24,420周期(SD±3,615),组2平均28,232周期(SD±5,417)。结论:低轮廓双钢板可以改善中轴锁骨骨折的初始稳定性,而不影响其长期性能,使其成为弹性钉的一种有希望的替代方案。对于单纯不稳定锁骨中轴骨折患者,2 × 2.0 mm双钢板可提供有效的生物力学稳定性。
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来源期刊
CiteScore
4.50
自引率
14.30%
发文量
311
审稿时长
3 months
期刊介绍: The European Journal of Trauma and Emergency Surgery aims to open an interdisciplinary forum that allows for the scientific exchange between basic and clinical science related to pathophysiology, diagnostics and treatment of traumatized patients. The journal covers all aspects of clinical management, operative treatment and related research of traumatic injuries. Clinical and experimental papers on issues relevant for the improvement of trauma care are published. Reviews, original articles, short communications and letters allow the appropriate presentation of major and minor topics.
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