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Published on: May 20, 2019
Biomechanical analysis of five fixation techniques used in glenohumeral arthrodesis
Bruce S Miller1, Wade P Harper, R Mark Gillies
1Orthopaedic Research Laboratories, The University of New South Wales, The Prince of Wales Hospital, Randwick, New South Wales, Australia. bsmiller@umich.edu
Background:
The purpose of the present study is to compare five fixation techniques in shoulder fusion. The most common complications resulting from shoulder fusion, non-union and unacceptable arm position, might reflect a failure to achieve rigid fixation during the surgical procedure.
Methods:
Twenty-five shoulder fusions were carried out on human cadaveric specimens using the following techniques: screw fixation, external fixation, external fixation supplemented with screw fixation, single plate fixation and double plate fixation. Each specimen was tested on a servohydraulic machine to determine stiffness.
Results:
There was a statistically significant difference in bending and torsional stiffness between all five fixation techniques. Normalized bending (B) and torsional stiffness (T), in descending order, were: double plate (B = 1.00, T = 1.00), single plate (B = 0.77, T = 0.89), external fixation with screws (B = 0.68, T = 0.74), external fixation alone (B = 0.40, T = 0.53), and screws alone (B = 0.13, T = 0.26).
Conclusion:
The risk of the most common complications resulting from shoulder fusion might be minimized if these biomechanical findings are applied to surgical decision making.
