Comparison of the fixation ability between lag screw and bone plate for oblique metacarpal shaft fracture.

Biomechanical Phenomena Bone Plates Bone Screws Fracture Fixation, Internal / methods Fractures, Bone / diagnostic imaging Hand Injuries Humans Metacarpal Bones / diagnostic imaging
Locked plate Oblique metacarpal shaft fracture Regular plate Screw

Journal

Journal of orthopaedic surgery and research
ISSN: 1749-799X
Titre abrégé: J Orthop Surg Res
Pays: England
ID NLM: 101265112

Informations de publication

Date de publication:
05 Feb 2022
Historique:
received: 30 12 2021
accepted: 24 01 2022
entrez: 6 2 2022
pubmed: 7 2 2022
medline: 23 3 2022
Statut: epublish

Résumé

For oblique metacarpal shaft fracture, if anatomical reduction is achieved through conservative cast immobilization rather than stable fixation, bone malrotation can easily occur, resulting in severe loss in hand prehensile function. However, whether bone plate fixation or only lag screw fixation is more preferable remains unclear. Few studies have evaluated whether screw fixation can provide biomechanical fixation strength similar to bone plate fixation. We assessed the difference in fixation strength between fixtation with two lag screws and bone plate for oblique metacarpal shaft fractures. We created oblique metacarpal shaft fractures on 21 artificial bones and fixated them using (1) double lag screw (2LS group), (2) regular plate (RP group), or (3) locked plate (LP group). To obtain the force-displacement data, a cantilever bending test was conducted for each specimen through a material testing machine. One-way analysis of variance and a Tukey test were conducted to compare the maximum fracture force and stiffness of the three fixation methods. The maximum fracture force of the 2LS group (mean + SD: 153.6 ± 26.5 N) was significantly lower than that of the RP (211.6 ± 18.5 N) and LP (227.5 ± 10.0 N) groups (p < 0.001). However, no significant differences were discovered between the RP and LP groups. The coefficient of variation for the maximum fracture force of the 2LS group (17.3%) was more than twice as high as that of the RP (8.7%) and LP (4.4%) groups. In addition, the stiffness of the three fixation methods was similar. Compared with bone plate fixation, double lag screw fixation yielded slightly lower maximum bearable fracture force but similar stiffness. Therefore, this technique could be used for treating oblique metacarpal shaft fractures. However, using double lag screw fixation alone is technically demanding and requires considerable surgical experiences to produce consistent results.

Sections du résumé

BACKGROUND BACKGROUND
For oblique metacarpal shaft fracture, if anatomical reduction is achieved through conservative cast immobilization rather than stable fixation, bone malrotation can easily occur, resulting in severe loss in hand prehensile function. However, whether bone plate fixation or only lag screw fixation is more preferable remains unclear. Few studies have evaluated whether screw fixation can provide biomechanical fixation strength similar to bone plate fixation.
OBJECTIVE OBJECTIVE
We assessed the difference in fixation strength between fixtation with two lag screws and bone plate for oblique metacarpal shaft fractures.
MATERIALS AND METHODS METHODS
We created oblique metacarpal shaft fractures on 21 artificial bones and fixated them using (1) double lag screw (2LS group), (2) regular plate (RP group), or (3) locked plate (LP group). To obtain the force-displacement data, a cantilever bending test was conducted for each specimen through a material testing machine. One-way analysis of variance and a Tukey test were conducted to compare the maximum fracture force and stiffness of the three fixation methods.
RESULTS RESULTS
The maximum fracture force of the 2LS group (mean + SD: 153.6 ± 26.5 N) was significantly lower than that of the RP (211.6 ± 18.5 N) and LP (227.5 ± 10.0 N) groups (p < 0.001). However, no significant differences were discovered between the RP and LP groups. The coefficient of variation for the maximum fracture force of the 2LS group (17.3%) was more than twice as high as that of the RP (8.7%) and LP (4.4%) groups. In addition, the stiffness of the three fixation methods was similar.
CONCLUSION CONCLUSIONS
Compared with bone plate fixation, double lag screw fixation yielded slightly lower maximum bearable fracture force but similar stiffness. Therefore, this technique could be used for treating oblique metacarpal shaft fractures. However, using double lag screw fixation alone is technically demanding and requires considerable surgical experiences to produce consistent results.

Identifiants

DOI: 10.1186/s13018-022-02963-3 PMID: 35123532 PMC: PMC8817463
pubmed: 35123532
doi: 10.1186/s13018-022-02963-3
pii: 10.1186/s13018-022-02963-3
pmc: PMC8817463
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

72

Subventions

Organisme : China Medical University, Taiwan
ID : CMU110-S-05

Informations de copyright

© 2022. The Author(s).

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Auteurs

Yung-Cheng Chiu (YC)

School of Medicine, China Medical University, Taichung, 404, Taiwan, ROC.
Department of Orthopedic Surgery, China Medical University Hospital, Taichung, 404, Taiwan, ROC.

Tsung-Yu Ho (TY)

Department of Orthopedic Surgery, China Medical University Hospital, Taichung, 404, Taiwan, ROC.

Cheng-En Hsu (CE)

Department of Orthopaedics, Taichung Veterans General Hospital, Taichung, 407, Taiwan, ROC.
Sports Recreation and Health Management Continuing Studies-Bachelor's Degree Completion Program, Tunghai University, Taichung, 407, Taiwan, ROC.

Yen-Nien Ting (YN)

3D Printing Medical Research Center, China Medical University Hospital, Taichung, 404, Taiwan, ROC.

Ming-Tzu Tsai (MT)

Department of Biomedical Engineering, Hungkuang University, Taichung, 433, Taiwan, ROC.

Jui-Ting Hsu (JT)

School of Dentistry, College of Dentistry, China Medical University, 91 Hsueh-Shih Road, Taichung, 40402, Taiwan, ROC. jthsu@mail.cmu.edu.tw.
Department of Bioinformatics and Medical Engineering, Asia University, Taichung, 413, Taiwan, ROC. jthsu@mail.cmu.edu.tw.
ORCID: 0000-0002-5533-2059

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Classifications MeSH

questionsmedicales.fr › Phénomènes physiques › Phénomènes mécaniques › Phénomènes biomécaniques › Comparison of the fixation ability between lag...
questionsmedicales.fr › Équipement et fournitures › Équipement chirurgical › Matériels de fixation chirurgicale › Appareils de fixation orthopédique › Fixateurs internes › Plaques orthopédiques › Comparison of the fixation ability between lag...
questionsmedicales.fr › Équipement et fournitures › Équipement chirurgical › Matériels de fixation chirurgicale › Appareils de fixation orthopédique › Fixateurs internes › Vis orthopédiques › Comparison of the fixation ability between lag...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures orthopédiques › Ostéosynthèse › Ostéosynthèse interne › Comparison of the fixation ability between lag...
questionsmedicales.fr › Plaies et blessures › Fractures osseuses › Comparison of the fixation ability between lag...
questionsmedicales.fr › Plaies et blessures › Blessures de la main › Comparison of the fixation ability between lag...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Comparison of the fixation ability between lag...
questionsmedicales.fr › Appareil locomoteur › Squelette › Os du membre supérieur › Os de la main › Os du métacarpe › Comparison of the fixation ability between lag...