Arzu Ufuk, Ersin Mehmet, Chodza Mehmet, Şahin Koray, Kiliçoğlu Önder, Erşen Ali
. VKV American Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey.
. Haseki Education and Research Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey.
Acta Ortop Bras. 2023 Jun 9;31(spe2):e260966. doi: 10.1590/1413-785220233102e260966. eCollection 2023.
Latarjet procedure is often preferred in recurrent shoulder dislocations accompanied by glenoid bone loss. It is observed that the superiority of bone graft fixation methods is still controversial. The aim of this study is to biomechanically compare the bone graft fixation methods in the Latarjet procedure.
15 third-generation scapula bone models were divided into 3 groups. Graft was fixated in the first group with fully-threaded cortical screws of 3.5mm diameter, in the second group two 16 mm partially-threaded cannulated screws of 4.5mm diameter, and in the third group via a mini plate and screw. The hemispherical humeral head was placed on the tip of the cyclic charge device, and thus, the charge applied to the coracoid graft was homogeneous.
No statistically significant difference was found between paired comparisons (p>0.05). The forces in 5 mm displacement in total vary between 502-857N. Total stiffness measurements ranged between 105 and 625; the mean value was 258.13±53.54 with no statistically significant difference by groups (p = 0.958).
This biomechanical study showed that there is no difference between three coracoid fixation options in terms of fixation strength. Unlike previous assumptions, plate fixation is not biomechanically superior to screw fixation. Surgeons should consider their personal preferences and experience in choosing fixation methods.
拉塔热手术常用于伴有肩胛盂骨缺损的复发性肩关节脱位。据观察，植骨固定方法的优越性仍存在争议。本研究的目的是对拉塔热手术中的植骨固定方法进行生物力学比较。
将15个第三代肩胛骨模型分为3组。第一组用直径3.5mm的全螺纹皮质螺钉固定移植骨，第二组用两个直径4.5mm、长度16mm的部分螺纹空心螺钉固定，第三组通过微型钢板和螺钉固定。将半球形肱骨头置于循环加载装置的尖端，从而使施加于喙突移植骨的载荷均匀。
配对比较之间未发现统计学显著差异（p>0.05）。5mm位移时的力总计在502 - 857N之间变化。总刚度测量值在105至625之间；平均值为258.13±53.54，各组间无统计学显著差异（p = 0.958）。
这项生物力学研究表明，三种喙突固定方法在固定强度方面没有差异。与先前的假设不同，钢板固定在生物力学上并不优于螺钉固定。外科医生在选择固定方法时应考虑个人偏好和经验。
