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Proximal versus Distal Screw Placement for Biceps Tenodesis: A Biomechanical Study

Purpose To assess the maximum and end torque of a fourth-generation composite humerus model with no screw inserted or with a screw inserted in the distal (subpectoral) position or proximal (suprapectoral) position. Methods 24 large-size, fourth-generation composite humeri were randomised to the cont...

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Published in:Journal of orthopaedic surgery (Hong Kong) 2016-08, Vol.24 (2), p.258-261
Main Authors: De Villiers, Daniel Johannes, Loh, Brian, Tacey, Mark, Keith, Prue
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description Purpose To assess the maximum and end torque of a fourth-generation composite humerus model with no screw inserted or with a screw inserted in the distal (subpectoral) position or proximal (suprapectoral) position. Methods 24 large-size, fourth-generation composite humeri were randomised to the control (n=8), proximal (n=8), or distal (n=8) group. For the latter 2 groups, an 8-mm-head interference screw (7times25 mm) was inserted at 1 cm proximal and 1 cm distal to the superior aspect of the insertion of the pectoralis major tendon, respectively. The maximum and end torque of each humerus was assessed. Results Respectively for the control, proximal, and distal groups, the maximum torque was 81.8, 78.7, and 74.3 Nm, and the end torque was 80.7, 78.6, and 71.8 Nm; only the difference between control and distal groups was significant (p=0.005 for maximum torque and p=0.033 for end torque). All fractures in both control and proximal groups involved the distal 1/3 humerus. In the distal group, the fractures involved either the distal 1/3 humerus (n=6) or the screw-hole (n=2); the difference between the 2 types of fracture was not significant in terms of maximum torque (75.7 vs. 70.0, p=0.086) or end torque (75.3 vs. 61.4, p=0.40). Conclusion Compared with proximal placement of an interference screw, distal placement decreased the maximum torque (though not significantly) and may increase the risk of proximal humeral fracture.
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Methods 24 large-size, fourth-generation composite humeri were randomised to the control (n=8), proximal (n=8), or distal (n=8) group. For the latter 2 groups, an 8-mm-head interference screw (7times25 mm) was inserted at 1 cm proximal and 1 cm distal to the superior aspect of the insertion of the pectoralis major tendon, respectively. The maximum and end torque of each humerus was assessed. Results Respectively for the control, proximal, and distal groups, the maximum torque was 81.8, 78.7, and 74.3 Nm, and the end torque was 80.7, 78.6, and 71.8 Nm; only the difference between control and distal groups was significant (p=0.005 for maximum torque and p=0.033 for end torque). All fractures in both control and proximal groups involved the distal 1/3 humerus. In the distal group, the fractures involved either the distal 1/3 humerus (n=6) or the screw-hole (n=2); the difference between the 2 types of fracture was not significant in terms of maximum torque (75.7 vs. 70.0, p=0.086) or end torque (75.3 vs. 61.4, p=0.40). Conclusion Compared with proximal placement of an interference screw, distal placement decreased the maximum torque (though not significantly) and may increase the risk of proximal humeral fracture.</description><identifier>ISSN: 1022-5536</identifier><identifier>EISSN: 2309-4990</identifier><identifier>DOI: 10.1177/1602400227</identifier><identifier>PMID: 27574274</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Biomechanical Phenomena ; Biomechanics ; Bone Screws ; Humans ; Humerus - surgery ; Models, Anatomic ; Muscle, Skeletal - surgery ; Shoulder ; Skin &amp; tissue grafts ; Tendons - surgery ; Tenodesis - instrumentation ; Tenodesis - methods ; Torque</subject><ispartof>Journal of orthopaedic surgery (Hong Kong), 2016-08, Vol.24 (2), p.258-261</ispartof><rights>2016 Asia Pacific Orthopaedic Association unless otherwise noted. 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Methods 24 large-size, fourth-generation composite humeri were randomised to the control (n=8), proximal (n=8), or distal (n=8) group. For the latter 2 groups, an 8-mm-head interference screw (7times25 mm) was inserted at 1 cm proximal and 1 cm distal to the superior aspect of the insertion of the pectoralis major tendon, respectively. The maximum and end torque of each humerus was assessed. Results Respectively for the control, proximal, and distal groups, the maximum torque was 81.8, 78.7, and 74.3 Nm, and the end torque was 80.7, 78.6, and 71.8 Nm; only the difference between control and distal groups was significant (p=0.005 for maximum torque and p=0.033 for end torque). All fractures in both control and proximal groups involved the distal 1/3 humerus. In the distal group, the fractures involved either the distal 1/3 humerus (n=6) or the screw-hole (n=2); the difference between the 2 types of fracture was not significant in terms of maximum torque (75.7 vs. 70.0, p=0.086) or end torque (75.3 vs. 61.4, p=0.40). Conclusion Compared with proximal placement of an interference screw, distal placement decreased the maximum torque (though not significantly) and may increase the risk of proximal humeral fracture.</description><subject>Biomechanical Phenomena</subject><subject>Biomechanics</subject><subject>Bone Screws</subject><subject>Humans</subject><subject>Humerus - surgery</subject><subject>Models, Anatomic</subject><subject>Muscle, Skeletal - surgery</subject><subject>Shoulder</subject><subject>Skin &amp; tissue grafts</subject><subject>Tendons - surgery</subject><subject>Tenodesis - instrumentation</subject><subject>Tenodesis - methods</subject><subject>Torque</subject><issn>1022-5536</issn><issn>2309-4990</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp9kd9P1TAYhhsikQN64x9glniBMZn267r-4A5QkIREonjddO033Mm2HtoN4b-3h4NgNPGq6ZunT_PmJeQV0PcAUn4AQRmnlDG5RRasorrkWtNnZAE5K-u6EjtkN6UlpaCZEs_JDpO15EzyBfl6EcNtN9i-uMGY5lR87NKUb99cxJ_FRW8dDjhORRticdQ5XKXiEsfgMXXpoDjMWRjQ_bBj59avptnfvSDbre0Tvnw498j3k0-Xx5_L8y-nZ8eH56XjUk5lU4vKyZYray0FD40GwZUHC1JQgRWTjZNaSM-F0kC5kpZXltaq1RUCg2qPnG28PtilWcXcIt6ZYDtzH4R4ZWycOtejaWnbUJVbo0Yua6W1Z14JplxD0TGVXW83rlUM1zOmyQxdctj3dsQwJwMKaqFAiTqjb_5Cl2GOY25qGOOcSqik_h8Fion1EMAy9W5DuRhSitg-1gBq1tuap20z_PpBOTcD-kf095gZ2N8AyV7hH__9q_oFdA6lRQ</recordid><startdate>201608</startdate><enddate>201608</enddate><creator>De Villiers, Daniel Johannes</creator><creator>Loh, Brian</creator><creator>Tacey, Mark</creator><creator>Keith, Prue</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><general>SAGE Publishing</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BVBZV</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope><scope>DOA</scope></search><sort><creationdate>201608</creationdate><title>Proximal versus Distal Screw Placement for Biceps Tenodesis: A Biomechanical Study</title><author>De Villiers, Daniel Johannes ; 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Methods 24 large-size, fourth-generation composite humeri were randomised to the control (n=8), proximal (n=8), or distal (n=8) group. For the latter 2 groups, an 8-mm-head interference screw (7times25 mm) was inserted at 1 cm proximal and 1 cm distal to the superior aspect of the insertion of the pectoralis major tendon, respectively. The maximum and end torque of each humerus was assessed. Results Respectively for the control, proximal, and distal groups, the maximum torque was 81.8, 78.7, and 74.3 Nm, and the end torque was 80.7, 78.6, and 71.8 Nm; only the difference between control and distal groups was significant (p=0.005 for maximum torque and p=0.033 for end torque). All fractures in both control and proximal groups involved the distal 1/3 humerus. In the distal group, the fractures involved either the distal 1/3 humerus (n=6) or the screw-hole (n=2); the difference between the 2 types of fracture was not significant in terms of maximum torque (75.7 vs. 70.0, p=0.086) or end torque (75.3 vs. 61.4, p=0.40). Conclusion Compared with proximal placement of an interference screw, distal placement decreased the maximum torque (though not significantly) and may increase the risk of proximal humeral fracture.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>27574274</pmid><doi>10.1177/1602400227</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record>
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source Sage Journals GOLD Open Access 2024
subjects Biomechanical Phenomena
Biomechanics
Bone Screws
Humans
Humerus - surgery
Models, Anatomic
Muscle, Skeletal - surgery
Shoulder
Skin & tissue grafts
Tendons - surgery
Tenodesis - instrumentation
Tenodesis - methods
Torque
title Proximal versus Distal Screw Placement for Biceps Tenodesis: A Biomechanical Study
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