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Anatomical and Biomechanical Stability of Single/Double Screw‐Cancellous Bone Fixations of Regan–Morry Type III Ulnar Coronoid Fractures in Adults: CT Measurement and Finite Element Analysis

OBJECTIVE: At present, it is still uncertain whether single screw has the same stability as double screws in the treatment of ulnar coronal process basal fracture (Regan–Morry type III). So, we aimed to compare the pull‐out force and anti‐rotation torque of anterior single/double screw‐cancellous bo...

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Autores principales: Ye, Hao, Yang, Yongchao, Xing, Tingyang, Tan, Guirong, Jin, Shuxun, Zhao, Zhichao, Zhang, Weikang, Li, Yanyan, Zhang, Lei, Wang, Jianshun, Zheng, Rongmei, Lu, Yun, Wu, Lijun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10102310/
https://www.ncbi.nlm.nih.gov/pubmed/36647280
http://dx.doi.org/10.1111/os.13664
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author Ye, Hao
Yang, Yongchao
Xing, Tingyang
Tan, Guirong
Jin, Shuxun
Zhao, Zhichao
Zhang, Weikang
Li, Yanyan
Zhang, Lei
Wang, Jianshun
Zheng, Rongmei
Lu, Yun
Wu, Lijun
author_facet Ye, Hao
Yang, Yongchao
Xing, Tingyang
Tan, Guirong
Jin, Shuxun
Zhao, Zhichao
Zhang, Weikang
Li, Yanyan
Zhang, Lei
Wang, Jianshun
Zheng, Rongmei
Lu, Yun
Wu, Lijun
author_sort Ye, Hao
collection PubMed
description OBJECTIVE: At present, it is still uncertain whether single screw has the same stability as double screws in the treatment of ulnar coronal process basal fracture (Regan–Morry type III). So, we aimed to compare the pull‐out force and anti‐rotation torque of anterior single/double screw‐cancellous bone fixation (aSSBF, aDSBF) in this fracture, and further study the influencing factors on anatomical and biomechanical stability of smart screw internal fixations. METHODS: A total of 63 adult volunteers with no history of elbow injury underwent elbow CT scanning with associated three‐dimensional reconstruction that enabled the measurements of bone density and fixed length of the proximal ulna and coronoid. The models of coronal process basal fracture, aSSBF and aDSBF, were developed and validated. Using the finite element model test, the sensitivity analysis of pull‐out force and rotational torque was carried out. RESULTS: The pull‐out force of aSSBF model was positively correlated with the density of the cancellous bone and linearly related to the fixed depth of the screw. The load pattern of pull‐out force of aDSBF model was similar to that of aSSBF model. The ultimate torque of aDSBF model was higher than that of aSSBF model, but the load pattern of ultimate torque of both models was similar to each other when the fracture reset was satisfactory, and the screw nut attaches closely to coronoid process. Moreover, with enhancement of initial pre‐tightening force, the increase of ultimate torque of both models was small. CONCLUSIONS: In addition to three pull‐out stability factors of smart screw fixations, fracture surface fitting degree and nut fitting degree are the other two important anatomical and biomechanical stability factors of smart screw fixations both for rotational stability. When all pull‐out stability and rotational stability factors meet reasonable conditions simultaneously, single or double screw fixation methods are stable for the treatments of ulnar coronoid basal fractures.
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spelling pubmed-101023102023-04-15 Anatomical and Biomechanical Stability of Single/Double Screw‐Cancellous Bone Fixations of Regan–Morry Type III Ulnar Coronoid Fractures in Adults: CT Measurement and Finite Element Analysis Ye, Hao Yang, Yongchao Xing, Tingyang Tan, Guirong Jin, Shuxun Zhao, Zhichao Zhang, Weikang Li, Yanyan Zhang, Lei Wang, Jianshun Zheng, Rongmei Lu, Yun Wu, Lijun Orthop Surg Research Articles OBJECTIVE: At present, it is still uncertain whether single screw has the same stability as double screws in the treatment of ulnar coronal process basal fracture (Regan–Morry type III). So, we aimed to compare the pull‐out force and anti‐rotation torque of anterior single/double screw‐cancellous bone fixation (aSSBF, aDSBF) in this fracture, and further study the influencing factors on anatomical and biomechanical stability of smart screw internal fixations. METHODS: A total of 63 adult volunteers with no history of elbow injury underwent elbow CT scanning with associated three‐dimensional reconstruction that enabled the measurements of bone density and fixed length of the proximal ulna and coronoid. The models of coronal process basal fracture, aSSBF and aDSBF, were developed and validated. Using the finite element model test, the sensitivity analysis of pull‐out force and rotational torque was carried out. RESULTS: The pull‐out force of aSSBF model was positively correlated with the density of the cancellous bone and linearly related to the fixed depth of the screw. The load pattern of pull‐out force of aDSBF model was similar to that of aSSBF model. The ultimate torque of aDSBF model was higher than that of aSSBF model, but the load pattern of ultimate torque of both models was similar to each other when the fracture reset was satisfactory, and the screw nut attaches closely to coronoid process. Moreover, with enhancement of initial pre‐tightening force, the increase of ultimate torque of both models was small. CONCLUSIONS: In addition to three pull‐out stability factors of smart screw fixations, fracture surface fitting degree and nut fitting degree are the other two important anatomical and biomechanical stability factors of smart screw fixations both for rotational stability. When all pull‐out stability and rotational stability factors meet reasonable conditions simultaneously, single or double screw fixation methods are stable for the treatments of ulnar coronoid basal fractures. John Wiley & Sons Australia, Ltd 2023-01-16 /pmc/articles/PMC10102310/ /pubmed/36647280 http://dx.doi.org/10.1111/os.13664 Text en © 2023 The Authors. Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Articles
Ye, Hao
Yang, Yongchao
Xing, Tingyang
Tan, Guirong
Jin, Shuxun
Zhao, Zhichao
Zhang, Weikang
Li, Yanyan
Zhang, Lei
Wang, Jianshun
Zheng, Rongmei
Lu, Yun
Wu, Lijun
Anatomical and Biomechanical Stability of Single/Double Screw‐Cancellous Bone Fixations of Regan–Morry Type III Ulnar Coronoid Fractures in Adults: CT Measurement and Finite Element Analysis
title Anatomical and Biomechanical Stability of Single/Double Screw‐Cancellous Bone Fixations of Regan–Morry Type III Ulnar Coronoid Fractures in Adults: CT Measurement and Finite Element Analysis
title_full Anatomical and Biomechanical Stability of Single/Double Screw‐Cancellous Bone Fixations of Regan–Morry Type III Ulnar Coronoid Fractures in Adults: CT Measurement and Finite Element Analysis
title_fullStr Anatomical and Biomechanical Stability of Single/Double Screw‐Cancellous Bone Fixations of Regan–Morry Type III Ulnar Coronoid Fractures in Adults: CT Measurement and Finite Element Analysis
title_full_unstemmed Anatomical and Biomechanical Stability of Single/Double Screw‐Cancellous Bone Fixations of Regan–Morry Type III Ulnar Coronoid Fractures in Adults: CT Measurement and Finite Element Analysis
title_short Anatomical and Biomechanical Stability of Single/Double Screw‐Cancellous Bone Fixations of Regan–Morry Type III Ulnar Coronoid Fractures in Adults: CT Measurement and Finite Element Analysis
title_sort anatomical and biomechanical stability of single/double screw‐cancellous bone fixations of regan–morry type iii ulnar coronoid fractures in adults: ct measurement and finite element analysis
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10102310/
https://www.ncbi.nlm.nih.gov/pubmed/36647280
http://dx.doi.org/10.1111/os.13664
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