Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Sinchon-dong, Seodaemun-gu, Seoul, 03722, Korea.
Surgical Anatomy Education Centre, Yonsei University College of Medicine, Seoul, Korea.
Sci Rep. 2023 Mar 6;13(1):3744. doi: 10.1038/s41598-023-30935-y.
No studies have evaluated the effect of fibular strut augmentation on the stability of locking plate fixation for osteoporotic proximal humeral fractures with lateral wall comminution. The purpose of this study was to evaluate the stability of locking plate fixation with a fibular strut graft compared with locking plate alone in an osteoporotic two-part surgical neck fracture model with lateral cortex comminution. Ten paired fresh-frozen cadaveric humeri were randomly allocated into two groups, either the locking plate alone (LP group) or locking plate with fibular strut graft augmentation (LPFSG group), with an equal number of right and left osteoporotic surgical neck fractures with lateral wall comminution of the greater tuberosity. Varus, internal/external torsion, and axial compression stiffness as well as single load to failure were measured in plate-bone constructs, and the LPFSG group showed significantly greater values in all metrics. In conclusion, this biomechanical study shows that fibular strut augmentation significantly enhances varus stiffness, internal torsion stiffness, external torsion stiffness, and maximum failure load of a construct compared to locking plate fixation alone in proximal humeral fractures with lateral wall comminution.
尚无研究评估腓骨支柱增强对伴有外侧壁粉碎的骨质疏松性肱骨近端骨折锁定钢板固定稳定性的影响。本研究旨在评估在伴有外侧皮质粉碎的骨质疏松性外科颈二部分骨折模型中，与单纯锁定钢板固定相比，腓骨支柱移植物增强的锁定钢板固定的稳定性。将 10 对新鲜冷冻的尸体肱骨头随机分配到两组，即单纯锁定钢板（LP 组）或锁定钢板加腓骨支柱移植物增强（LPFSG 组），每组右侧和左侧均有伴有大结节外侧壁粉碎的骨质疏松性外科颈骨折。在钢板-骨结构中测量内翻、内/外翻扭转和轴向压缩刚度以及单次失效负荷，LPFSG 组在所有指标上的数值均显著更大。总之，这项生物力学研究表明，与单纯锁定钢板固定相比，腓骨支柱增强可显著增加伴有外侧壁粉碎的肱骨近端骨折结构的内翻刚度、内扭转刚度、外扭转刚度和最大失效负荷。
