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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Musculoskeletal Disorders 1/2015

A scoping review of biomechanical testing for proximal humerus fracture implants

Zeitschrift:
BMC Musculoskeletal Disorders > Ausgabe 1/2015
Autoren:
David Cruickshank, Kelly A. Lefaivre, Herman Johal, Norma J. MacIntyre, Sheila A. Sprague, Taryn Scott, Pierre Guy, Peter A. Cripton, Michael McKee, Mohit Bhandari, Gerard P. Slobogean
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12891-015-0627-x) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

DC participated in acquisition and interpretation of data and participated in manuscript review and critical appraisal and revision. KAL participated in acquisition and interpretation of data and participated in manuscript review and critical appraisal and revision. HJ participated in the acquisition and interpretation of data and participated manuscript review and critical appraisal and revision. NJM participated in the interpretation of data and in manuscript review and critical appraisal and revision. SAS participated in project design and coordination and helped to draft the manuscript. TS participated in the gathering and analysis of data and helped to draft the manuscript. PG participated in the interpretation of the data with regard to clinical relevance in orthopaedic surgery and participated in manuscript review and critical appraisal and revision. PAC participated in the interpretation of the data with regard to relevance in biomechanics and participated in manuscript review and critical appraisal and revision. MM participated in the interpretation of the data with regard to clinical relevance in orthopaedic surgery and participated in manuscript review and critical appraisal and revision. MB participated in project design and participated in manuscript review and critical appraisal and revision. GPS conceived the project and participated in its design, the interpretation and analysis of data, and manuscript review and critical appraisal and revision. All authors read and approved the final manuscript.

Abstract

Background

Fixation failure is a relatively common sequela of surgical management of proximal humerus fractures (PHF). The purpose of this study is to understand the current state of the literature with regard to the biomechanical testing of proximal humerus fracture implants.

Methods

A scoping review of the proximal humerus fracture literature was performed, and studies testing the mechanical properties of a PHF treatment were included in this review. Descriptive statistics were used to summarize the characteristics and methods of the included studies.

Results

1,051 proximal humerus fracture studies were reviewed; 67 studies met our inclusion criteria. The most common specimen used was cadaver bone (87 %), followed by sawbones (7 %) and animal bones (4 %). A two-part fracture pattern was tested most frequently (68 %), followed by three-part (23 %), and four-part (8 %). Implants tested included locking plates (52 %), intramedullary devices (25 %), and non-locking plates (25 %). Hemi-arthroplasty was tested in 5 studies (7 %), with no studies using reverse total shoulder arthroplasty (RTSA) implants. Torque was the most common mode of force applied (51 %), followed by axial loading (45 %), and cantilever bending (34 %). Substantial testing diversity was observed across all studies.

Conclusions

The biomechanical literature was found to be both diverse and heterogeneous. More complex fracture patterns and RTSA implants have not been adequately tested. These gaps in the current literature will need to be addressed to ensure that future biomechanical research is clinically relevant and capable of improving the outcomes of challenging proximal humerus fracture patterns.
Zusatzmaterial
Additional file 1: Studies included in the analysis. (DOCX 28 kb)
12891_2015_627_MOESM1_ESM.docx
Additional file 2: Implants tested in each included study. (XLSX 46 kb)
12891_2015_627_MOESM2_ESM.xlsx
Literatur
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