Can a coracoclavicular screw added to the clavicular hook plate reduce subacromial stress? A finite element analysis

Abstract

Objectives: The aim of this study was to investigate the stresses on the plate and the clavicle in the standard clavicular hook plate model and the clavicular hook plate models with a coracoclavicular (CC) screw by finite element analysis (FEA).

Materials and methods: The FEA models were created with the combination of acromion, clavicle, coracoid process, 8-hole clavicular hook plate and screw components. Model 1 was created as a standard clavicular hook plate model and plates were implanted to the clavicle and the acromion by six locking screws. Model 2 was created by a cortical screw placed in the coracoid process through the third hole of the plate (CC screw) and fixation of hook plate by five locking screws. The upward-pull force was applied to clavicle at the insertion of sternocleidomastoid muscle with three axes. The stress exerted by acromion on the hook of the plate, stresses on the plate, clavicle, and CC screw were analyzed.

Results: When the screw holes were compared, in Model 1, the highest stress was found in the last hole of the plate. In Model 2, the highest stress was detected on the CC screw. The stress on the clavicle was found to be 0.14 Mpa in Model 1 and 0.21 Mpa in Model 2. In Model 1 and Model 2, the stress exerted by acromion on the subacromial part of the plate was found to be 2.05 KPa and 1.66x10-6 KPa, respectively.

Conclusion: The results of this study show that addition of CC screw to the standard clavicular hook plate shares the loading and reduces the stress on the hook of the plate.

Citation: Kumbaracı M, Özer A, Bozoğlan M, Turgut A. Can a coracoclavicular screw added to the clavicular hook plate reduce subacromial stress? A finite element analysis. Jt Dis Relat Surg 2022;33(3):609-615.

The study protocol was approved by the Tepecik Training and Research Hospital Ethics Committee (date: 16.11.2020, no: 2020/13-16). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Data Sharing Statement:
The data that support the findings of this study are available from the corresponding author upon reasonable request.

Material preparation and data collection: M.K., A.Ö., M.B.; Supervision: A.T., Data collection and processing: A.Ö., M.K., M.B., Analysis and/or interpretation: A.Ö., M.K., Literature search: M.K., M.B., A.T., Writing manuscript: M.K., A.T., Critical review: A.T., A.Ö.

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

The authors received no financial support for the research and/or authorship of this article.