Orthopedics. 2022 Nov-Dec;45(6):e321-e325. doi: 10.3928/01477447-20220805-01. Epub 2022 Aug 10.
We compared the strength of screw vs suture button fixation in the Latarjet procedure for shoulder dislocation through biomechanical testing in a cadaver model. Cadavers were assigned randomly to receive screw or suture button fixation (both groups, n=5). The anteroposterior radius of the glenoid was measured, and a bony defect was created on the anteroinferior rim of the glenoid, equal to 25% of the width of the anteroposterior radius of the glenoid surface. The coracoid process was transferred into the newly created bony defect of the glenoid and fixed with two 3.5-mm partially threaded cannulated screws or 2 surgical buttons. All samples underwent tensile testing in the anteroinferior direction. Statistical analysis was performed to compare mean forces at failure between groups (alpha=.05). The mean force at failure was higher in the screw group (295 N; range, 103-534 N) than in the suture button group (133 N; range, 74-270 N) (=.045). We found no difference between groups in ability to withstand a force of 150 N, which is the reported mean daily force threshold borne by the shoulder (=.52). Screw fixation withstood a higher failure load than suture button fixation, indicating that screw fixation is a biomechanically superior option in the Latarjet procedure. The fixation methods did not differ in their ability to withstand the mean force borne by the shoulder during activities of daily living; thus, suture button fixation should be considered as an option in the Latarjet procedure. [. 2022;45(6):e321-e325.].
我们通过尸体模型的生物力学测试比较了肩脱位 Latarjet 手术中螺钉与缝线纽扣固定的强度。将尸体随机分配接受螺钉或缝线纽扣固定(两组,n=5)。测量关节盂前后半径,并在关节盂前下边缘创建一个骨缺损,等于关节盂前后半径的 25%。喙突转移到新创建的关节盂骨缺损中,并使用两个 3.5 毫米的部分螺纹空心螺钉或 2 个手术纽扣固定。所有样本均在前后方向进行拉伸测试。进行统计分析以比较组间失效时的平均力(alpha=.05)。螺钉组的失效时平均力较高(295 N;范围,103-534 N),缝线纽扣组较低(133 N;范围,74-270 N)(=.045)。我们发现两组在承受 150 N 力的能力方面没有差异,这是报告的肩部承受的平均每日力阈值(=.52)。螺钉固定比缝线纽扣固定承受更高的失效负荷,表明螺钉固定是 Latarjet 手术中生物力学上更优的选择。固定方法在承受日常生活活动中肩部承受的平均力方面没有差异;因此,缝线纽扣固定应被视为 Latarjet 手术中的一种选择。[. 2022;45(6):e321-e325.].