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[Biomechanical investigation on refixation of tuberosities on shoulder prostheses. Does refixation with different
J Fleischer1, A Schleyer, R Nassutt
1Klinik für Orthopädie und Unfallchirurgie, Marienkrankenhaus St. Wendel, Am Hirschberg, 66606, St. Wendel, Germany. j.fleischer@wnd.marienhaus-gmbh.de
Background:
Elderly patients suffering from complex, non-reconstructable fractures of the proximal humerus are commonly treated by primary implantation of a shoulder endoprosthesis. One of the most critical factors for success or failure of treatment is still the refixation of the tuberosities.
Method:
Using sheep infraspinatus tendons with attached tuberosities three different suture materials were investigated. For 2 of the suture materials 4 tests were accomplished and 5 tests were carried out for the third suture material. A material testing machine was used to perform cyclic loading tests (20 mm/min, Fmin=50 N, Fmax=100 N, respectively after 50 cycles: Fmax+50 N until failure).
Results:
The results showed large variations in the average maximum forces (152.4 N for suture 1, 219.9 N for suture 2 and 452.3 N for suture 3). All tests showed a high initial lengthening and caused incision-like defects in the bone or tendon and led to failure and high displacement of the tuberosities.
Conclusion:
Due to these results suture materials have a limited usefulness for refixation of tuberosities as an increased risk of obstruction for bony consolidation can result.