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  • Title: Cadaveric-biomechanical evaluation of bone-implant construct of proximal humerus fractures (Neer type 3).
    Author: Fankhauser F, Schippinger G, Weber K, Heinz S, Quehenberger F, Boldin C, Bratschitsch G, Szyszkowitz R, Georg L, Friedrich A.
    Journal: J Trauma; 2003 Aug; 55(2):345-9. PubMed ID: 12913647.
    Abstract:
    BACKGROUND: A biomechanical cadaver study was performed to test the stability and strength of screw osteosynthesis of surgical neck fractures of the humerus. METHODS: After bone density measurement, 64 cadaver proximal humerus bones were bent to create a subcapital fracture. The fracture was then stabilized by means of screw osteosynthesis randomly assigned to subgroups of screw positioning, size of screw, and stress test (torsion/bending). RESULTS: Two screws applied laterally and parallel were 34.2% more stable than the normal arrangement. Bone density had a dominant role with regard to maximal bending and torsion force, but no significance was found with respect to additional screws through the major tuberculum or diameter of screws. CONCLUSION: Two of the smaller 4.5-mm cannulated screws should be applied parallel from the lateral direction. Only range-of-motion exercises that produce a bending stress should be considered early after surgery, avoiding axial stress.
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