2020 journal article
A Biomechanical Comparison of Modified Radioscapholunate Fusion Constructs for Radiocarpal Arthritis
JOURNAL OF HAND SURGERY-AMERICAN VOLUME, 45(10).
author keywords: Biomechanical performance; cadaveric model; headless screws; pin plates; plates and screws
MeSH headings : Arthritis; Arthrodesis; Biomechanical Phenomena; Bone Plates; Bone Screws; Cadaver; Humans; Wrist Joint / surgery
TL;DR:
Plate-and-screw and pin-plate constructs are biomechanically superior in resisting RSL distraction compared with headless compression screws for RSL arthrodesis over 6 weeks of simulated ROM in the absence of healing.
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(Web of Science)
Source: Web Of Science
Added: October 26, 2020
{"Label"=>"PURPOSE", "NlmCategory"=>"OBJECTIVE"} This biomechanical study compared fixation constructs used in radioscapholunate (RSL) arthrodesis. We hypothesized that plates and screws, pin plate, and headless screws would all provide similarly stable fixation constructs. {"Label"=>"METHODS", "NlmCategory"=>"METHODS"} We chose 27 fresh-frozen cadaveric extremities, 14 of which were matched pairs and randomized them into 3 groups to match age, body mass index, and sex. An RSL arthrodesis was simulated with plates and screws, pin plates, or headless compression screws via a standard dorsal approach to the wrist. Specimens were mounted into a custom jig and cycled through an arc of 120° for 5,000 cycles to simulate 6 weeks range of motion (ROM). A 9-mm stroke differential variable reluctance transducer recorded continuous displacement, and gross hardware failure in the form of screw or pin cutout was investigated after the simulation. {"Label"=>"RESULTS", "NlmCategory"=>"RESULTS"} Greater distraction across the RSL articulation was observed in the headless screws compared with the plate-and-screws and pin-plate constructs, with no difference between the plates and screws and pin plates. Greater average displacement was observed in the headless screws compared with the plate-and-screws and pin-plate constructs, with no difference between the pin plates and plates and screws. Gross hardware failure was observed least in plates and screws followed by pin plates. {"Label"=>"CONCLUSIONS", "NlmCategory"=>"CONCLUSIONS"} Plate-and-screw and pin-plate constructs are biomechanically superior in resisting RSL distraction compared with headless compression screws for RSL arthrodesis over 6 weeks of simulated ROM in the absence of healing. {"Label"=>"CLINICAL RELEVANCE", "NlmCategory"=>"CONCLUSIONS"} The results of this study demonstrated negligible arthrodesis site distraction in the plate-and-screws and pin-plate constructs when 6 weeks of ROM was simulated. When translated to a clinical scenario, these findings may allow earlier discontinuation of external immobilization after surgery.