Fixation of Regan-Morrey Type II Coronoid Fractures: A Comparison of Screws and Suture Lasso Technique for Resistance to Displacement.

Fixation of Regan-Morrey Type II Coronoid Fractures: A Comparison of Screws and Suture Lasso Technique for Resistance to Displacement. - 2017

Available in print through MWHC library: 1999 - 2002, Available online from MWHC library: 1995 - present

CLINICAL RELEVANCE: Clinical studies have reported a higher rate of failure after screw fixation compared with suture lasso fixation; however, this study demonstrated a greater stiffness and load to failure after screw fixation of type II coronoid fractures. Screw fixation may provide a stronger fixation construct for fractures of adequate size to support a screw. Further studies may be warranted to assess the importance of securing the anterior capsule to the coronoid tip when using a suture lasso construct because this may affect the stability of the elbow after fixation. CONCLUSIONS: Screw fixation was biomechanically superior to fixation using a suture lasso technique. For coronoid fractures in which screw or suture fixation is feasible, screw fixation may provide greater resistance to displacement of the coronoid compared with a suture lasso technique. Copyright (c) 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved. METHODS: We performed a biomechanical study using 10 pairs of fresh-frozen cadaveric elbows. A transverse osteotomy at the midpoint of the coronoid height was created to simulate a Regan-Morrey type II coronoid fracture. The specimens were randomized to screw fixation or suture lasso fixation. The load to failure and stiffness were then measured using a materials testing machine. PURPOSE: The aim of this study was to compare the load to failure and stiffness achieved in coronoid fractures treated with a posterior-to-anterior screw versus a suture lasso technique. RESULTS: Screw fixation provided greater strength and stiffness than suture lasso fixation. Mean load to failure was 405 N in the screw fixation group compared with a load to failure of 207 N for suture fixation. Screw fixation resulted in a mean stiffness of 284 kPa/mm compared with 119 kPa/mm after suture fixation.


English

0363-5023


*Bone Screws
*Elbow Joint/in [Injuries]
*Elbow Joint/su [Surgery]
*Fracture Fixation, Internal/is [Instrumentation]
*Suture Techniques
*Ulna Fractures/su [Surgery]
Biomechanical Phenomena
Cadaver
Equipment Failure Analysis
Humans
Materials Testing


Curtis National Hand Center
MedStar Union Memorial Hospital


Orthopaedic Surgery


Comparative Study
Journal Article

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