Role of an additional third screw in the fixation of transverse patellar fracture with two parallel cannulated screw and
- PDF / 5,098,922 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 77 Downloads / 176 Views
(2020) 21:752
RESEARCH ARTICLE
Open Access
Role of an additional third screw in the fixation of transverse patellar fracture with two parallel cannulated screw and anterior wire Chih-Wei Chang1,2, Chih-Hsien Chen3, Chun-Ting Li4, Yen-Nien Chen5*, Tai-Hua Yang1,2,6,7,8*, Chia-Jung Chang6 and Chih-Han Chang6,8
Abstract Background: Two parallel cannulated screws along with an anterior wire to construct a tension band is a popular approach in transverse patellar fractures. However, the optimal screw proximity, either deep or superficial screw placements, remains controversial. Hence, a new concept of the addition of a third screw to form a triangular configuration along with the original two parallel screws was proposed in this study. Therefore, the biomechanical effect of the additional third screw on the stability of the fractured patella was investigated with finite element (FE) simulation. Methods: An FE knee model including the distal femur, proximal tibia, and fractured patella (type AT/OTA 34-C) was developed in this study. Four different screw configurations, including two parallel cannulated screws with superficial (5-mm proximity) and deep (10-mm proximity) placements and two parallel superficial screws plus a third deep screw, and two parallel deep screws plus a third superficial screw, with or without the anterior wire, were considered for the simulation. Results: Results indicated that the addition of a third screw increased stability by reducing the dorsal gap opening when two parallel screws were deeply placed, particularly on the fractured patella without an anterior wire. However, the third screw was of little value when two parallel screws were superficially placed. In the existence of two deep parallel screws and the anterior wire, the third screw reduced the gap opening by 23.5% (from 1.15 mm to 0.88 mm) and 53.6% (from 1.21 mm to 0.61 mm) in knee flexion 45° and full extension, respectively. Furthermore, in the absence of the anterior wire, the third screw reduced the gap opening by 73.5% (from 2 mm to 0.53 mm) and 72.2% (from 1.33 mm to 0.37 mm) in knee flexion 45° and full extension, respectively. (Continued on next page)
* Correspondence: [email protected]; [email protected]; [email protected] 5 Department of Physical Therapy, Asia University, 500, Lioufeng Rd, Wufeng, Taichung City 41354, Taiwan 1 Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Co
Data Loading...
