Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2017

Open Access 01-12-2017 | Research article

Comparison of three different fixation constructs for radial neck fractures: a biomechanical study

Authors: Hongwei Chen, Dengying Wu, Tianlong Pan, Jun Pan, Rui Zhang, Xuchao Shi

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2017

Login to get access

Abstract

Background

Fixation of radial neck fractures can be achieved with a plate and screw construct or with two screws. This study evaluated the biomechanical properties of three different fixation methods following radial neck fractures.

Methods

Twenty-four fourth-generation composite radii were sawed to simulate an unstable radial neck fracture. They were then instrumented with a plate and screw construct or two different orientations (crossed and parallel) of screw fixation. Implants were tested under bending and torsional loads via a tension torsion composite test system. Bending and torsional failure loads were added to the remaining implant-radius constructs if they did not fail during the previous tests.

Results

During the bending loading test, the crossed-screw group showed the greatest stiffness, followed by the parallel-screw group, the plate group demonstrating the weakest stiffness. There was no significant difference between the crossed- and the parallel-screw groups. However, there was a significant difference between the two screw groups and the plate group. During the bending failure test, the largest stiffness was found for the crossed-screw group, while the plate group exhibited the smallest stiffness. There was a significant difference between the three groups. During the torsion loading test, the highest stiffness was observed for the crossed-screw group, while the plate group showed the lowest stiffness. In the torsion failure test, the failure torques were 11.97 ± 2.659, 8.531 ± 1.768, and 7.079 ± 1.666 N m respectively for the crossed-screw, parallel-screw, and plate groups. There was a significant difference between the crossed-screw group and the two other groups.

Conclusions

Crossed screws and plate fixation are commonly used in clinical practice to treat simple radial neck fractures. While the present study shows that the parallel-screw method results in similar biomechanical strength as the two other techniques, it has the advantages of reaching limited wound exposure and having the implant buried. Therefore, it may be widely used in clinical practice.
Literature
1.
Duckworth AD, Clement ND, Jenkins PJ, Aitken SA, Court-Brown CM, MM MQ. The epidemiology of radial head and neck fractures. J Hand Surg Am. 2012 Jan;37(1):112–9.CrossRefPubMed
2.
Rhyou IH, Kim KC, Kim KW, Lee JH, Kim SY. Collateral ligament injury in the displaced radial head and neck fracture: correlation with fracture morphology and management strategy to the torn ulnar collateral ligament. J Shoulder Elb Surg. 2013;22(2):261–7.CrossRef
3.
Rosenblatt Y, Athwal GS, Faber KJ. Current recommendations for the treatment of radial head fractures. Orthop Clin North Am. 2008;39(2):173–85. viCrossRefPubMed
4.
Shepard MF, Markolf KL, Dunbar AM. Effects of radial head excision and distal radial shortening on load-sharing in cadaver forearms. J Bone Joint Surg Am. 2001;83-A(1):92–100.CrossRefPubMed
5.
Esser RD, Davis S, Taavao T. Fractures of the radial head treated by internal fixation: late results in 26 cases. J Orthop Trauma. 1995;9(4):318–23.CrossRefPubMed
6.
Geel CW, Palmer AK, Ruedi T, Leutenegger AF. Internal fixation of proximal radial head fractures. J Orthop Trauma. 1990;4(3):270–4.CrossRefPubMed
7.
Sanders RA, French HG. Open reduction and internal fixation of comminuted radial head fractures. Am J Sports Med. 1986;14(2):130–5.CrossRefPubMed
8.
Zwingmann J, Welzel M, Dovi-Akue D, Schmal H, Sudkamp NP, Strohm PC. Clinical results after different operative treatment methods of radial head and neck fractures: a systematic review and meta-analysis of clinical outcome. Injury. 2013;44(11):1540–50.CrossRefPubMed
9.
Mason ML. Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg. 1954;42(172):123–32.CrossRefPubMed
10.
Broberg MA, Morrey BF. Results of treatment of fracture-dislocations of the elbow. Clin Orthop Relat Res. 1987;216:109–19.
11.
Johnston GW. A follow-up of one hundred cases of fracture of the head of the radius with a review of the literature. Ulster Med J. 1962;31:51–6.PubMedPubMedCentral
12.
Burkhart KJ, Mueller LP, Krezdorn D, Appelmann P, Prommersberger KJ, Sternstein W, Rommens PM. Stability of radial head and neck fractures: a biomechanical study of six fixation constructs with consideration of three locking plates. J Hand Surg Am. 2007;32(10):1569–75.CrossRefPubMed
13.
Capo JT, Svach D, Ahsgar J, Orillaza NS, Sabatino CT. Biomechanical stability of different fixation constructs for ORIF of radial neck fractures. Orthopedics. 2008 Oct;31(10)
14.
Giffin JR, King GJ, Patterson SD, Johnson JA. Internal fixation of radial neck fractures: an in vitro biomechanical analysis. Clin Biomech (Bristol, Avon). 2004 May;19(4):358–61.CrossRef
15.
Patterson JD, Jones CK, Glisson RR, Caputo AE, Goetz TJ, Goldner RD. Stiffness of simulated radial neck fractures fixed with 4 different devices. J Shoulder Elb Surg. 2001;10(1):57–61.CrossRef
16.
Smith AM, Morrey BF, Steinmann SP. Low profile fixation of radial head and neck fractures: surgical technique and clinical experience. J Orthop Trauma. 2007;21(10):718–24.CrossRefPubMed
17.
Smith GR, Hotchkiss RN. Radial head and neck fractures: anatomic guidelines for proper placement of internal fixation. J Shoulder Elb Surg. 1996;5(2 Pt 1):113–7.CrossRef
18.
Gutowski CJ, Darvish K, Ilyas AM, Jones CM. Comparison of crossed screw versus plate fixation for radial neck fractures. Clin Biomech (Bristol, Avon). 2015 Nov;30(9):966–70.CrossRef
19.
Berschback JC, Lynch TS, Kalainov DM, Wysocki RW, Merk BR, Cohen MS. Clinical and radiographic comparisons of two different radial head implant designs. J Shoulder Elb Surg. 2013;22(8):1108–20.CrossRef
20.
Duckworth AD, McQueen MM, Ring D. Fractures of the radial head. Bone Joint J. 2013;95-B(2):151–9.CrossRefPubMed
21.
Hall JA, McKee MD. Posterolateral rotatory instability of the elbow following radial head resection. J Bone Joint Surg Am. 2005;87(7):1571–9.PubMed
22.
Ikeda M, Oka Y. Function after early radial head resection for fracture: a retrospective evaluation of 15 patients followed for 3–18 years. Acta Orthop Scand. 2000;71(2):191–4.CrossRefPubMed
23.
Karlsson MK, Herbertsson P, Nordqvist A, Besjakov J, Josefsson PO, Hasserius R. Comminuted fractures of the radial head. Acta Orthop. 2010;81(2):224–7.CrossRefPubMedPubMedCentral
24.
Ring D. Open reduction and internal fixation of fractures of the radial head. Hand Clin. 2004;20(4):415–27. viCrossRefPubMed
25.
Ikeda M, Sugiyama K, Kang C, Takagaki T, Oka Y. Comminuted fractures of the radial head. Comparison of resection and internal fixation. J Bone Joint Surg Am. 2005;87(1):76–84.PubMed
26.
Li SL, Lu Y, Wang MY. Is cross-screw fixation superior to plate for radial neck fractures? Bone Joint J. 2015;97-B(6):830–5.CrossRefPubMed
Metadata
Title
Comparison of three different fixation constructs for radial neck fractures: a biomechanical study
Authors
Hongwei Chen
Dengying Wu
Tianlong Pan
Jun Pan
Rui Zhang
Xuchao Shi
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2017
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-017-0680-2

Other articles of this Issue 1/2017

Journal of Orthopaedic Surgery and Research 1/2017 Go to the issue

Research article

The correlation between the high-intensity zone on a T2-weighted MRI and positive outcomes of discography: a meta-analysis

Research article

Radial extracorporeal shock wave therapy is efficient and safe in the treatment of fracture nonunions of superficial bones: a retrospective case series

Research article

Trajectory of instantaneous axis of rotation in fixed lumbar spine with instrumentation

Research article

An anatomical-like triangular-vector ligament reconstruction for the medial collateral ligament and the posterior oblique ligament injury with single femoral tunnel: a retrospective study

Research article

Treatment and outcome prognosis of patients with high-energy transsyndesmotic ankle fracture dislocation—the “Logsplitter” injury

Research article

The medial femoral wall can play a more important role in unstable intertrochanteric fractures compared with lateral femoral wall: a biomechanical study