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

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Citation: Journal of Hand Surgery - American Volume. 42(1):e11-e14, 2017 JanPMID: 28052832Institution: Curtis National Hand Center | MedStar Union Memorial HospitalDepartment: Orthopaedic SurgeryForm of publication: Journal ArticleMedline article type(s): Comparative Study | Journal ArticleSubject headings: *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 TestingYear: 2017 Local holdings: Available in print through MWHC library: 1999 - 2002, Available online from MWHC library: 1995 - presentISSN:

0363-5023

Name of journal: The Journal of hand surgeryAbstract: 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.All authors: Iannuzzi NP, Murphy MS, Paez AG, Parks BGFiscal year: FY2017Digital Object Identifier:

https://dx.doi.org/10.1016/j.jhsa.2016.11.003

Date added to catalog: 2017-12-13

Holdings ( 1 )
Title notes ( 8 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	28052832	Available		28052832

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.

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.

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