Biomechanical comparison of three fixation strategies for radial head fractures: a biomechanical study

Second-generation headless compression screws (HCSs) are commonly used for the fixation of small bones and articular fractures. However, there is a lack of biomechanical data regarding the application of such screws to radial head fractures. This study evaluated the mechanical properties of the fixation of radial head fractures using a single oblique HCS compared with those obtained using a standard locking radial head plate (LRHP) construct and a double cortical screw (DCS) construct. Radial synbone models were used for biomechanical tests of HCS, LRHP, and DCS constructs. All specimens were first cyclically loaded and then loaded to failure. The stiffness for the LRHP group was significantly higher than that for the other two groups, and that for the HCS group was significantly higher than that for the DCS group. The LRHP group had the greatest strength, followed by the HCS group and then the DCS group. The HCS construct demonstrated greater fixation strength than that of the commonly used cortical screws, although the plate group was the most stable. The present study revealed the feasibility of using a single oblique HCS, which has the advantages of being buried, requiring limited wound exposure, and having relatively easy operation, for treating simple radial head fractures.

Automated summary

Second-generation headless compression screws (HCSs) are commonly used for the fixation of small bones and articular fractures. This study evaluated the mechanical properties of radial head fractures fixation using a single oblique HCS compared with a standard locking radial head plate (LRHP) and a double cortical screw (DCS) construct. The LRHP group showed the highest stiffness and strength, followed by the HCS group and then the DCS group. The HCS construct demonstrated greater fixation strength than the commonly used cortical screws.