• Arch Orthop Trauma Surg · Sep 2021

    Comparative Study

    Biomechanical comparison of screw osteosyntheses and anatomical plating for coronoid shear fractures of the ulna.

    • Valentin Rausch, Birger Jettkant, Sebastian Lotzien, Thomas Rosteius, Eileen Mempel, Thomas A Schildhauer, Dominik Seybold, Jan Geßmann, and Matthias Königshausen.
    • Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany. rauschv@gmail.com.
    • Arch Orthop Trauma Surg. 2021 Sep 1; 141 (9): 1509-1515.

    IntroductionAmong the few techniques described for the treatment of coronoid fractures, osteosynthesis techniques include screw osteosynthesis from anterior to posterior (AP) or from posterior to anterior (PA) and plate osteosynthesis. The aim of this study was to test the biomechanical stability of screw osteosynthesis and plate osteosynthesis using anatomical plates in coronoid process fractures.Materials And MethodsOn a total of 25 biomechanical synthetical ulnae, a coronoid shear fracture including 70% of the coronoid height was simulated. Osteosynthesis was then performed using two 2.7 mm screws from anterior, posterior and with use of three different anatomical plates of the coronoid process. For the biomechanical testing, axial load was applied to the fragment with 1000 cycles from 5 to 250 N, load to failure and load at 100 µm displacement. Displacements were measured using a point-based three-dimensional motion analysis system.ResultsOsteosynthesis using the PA-screw showed significant more displacement during cyclic loading compared with all other osteosyntheses (0.99 mm), whereas AP-screw showed the smallest displacement (0.10 mm) during cyclic loading. The PA-screw technique showed a significant lower load to failure compared to all other osteosynthesis with the highest load in AP-screw osteosynthesis. The load for 100 µm displacement was the smallest in PA-screw with a significant difference to the AP-screw and one plate osteosynthesis.ConclusionOsteosynthesis of large coronoid shear fractures with two small-fragment screws from anterior allows stable fixation that is not inferior to anterior plate osteosynthesis and might be an alternative in specific fracture types. Posterior screw fixation was found as the weakest fixation method.Level Of EvidenceBasic science study.© 2020. The Author(s).

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