title: Fixation of Regan-Morrey Type II Coronoid Fractures: A Comparison of Screws and Suture Lasso Technique for Resistance to Displacement.
abstract: OBJECTIVE
  The aim of this study was to compare the load to failure and stiffness achieved in coronoid fractures treated with a posterior-to-anterior screw versus a suture lasso technique.
  
  
  METHODS
  We performed a biomechanical study using 10 pairs of fresh-frozen cadaveric elbows. A transverse osteotomy at the midpoint of the coronoid height was created to simulate a Regan-Morrey type II coronoid fracture. The specimens were randomized to screw fixation or suture lasso fixation. The load to failure and stiffness were then measured using a materials testing machine.
  
  
  RESULTS
  Screw fixation provided greater strength and stiffness than suture lasso fixation. Mean load to failure was 405 N in the screw fixation group compared with a load to failure of 207 N for suture fixation. Screw fixation resulted in a mean stiffness of 284 kPa/mm compared with 119 kPa/mm after suture fixation.
  
  
  CONCLUSIONS
  Screw fixation was biomechanically superior to fixation using a suture lasso technique. For coronoid fractures in which screw or suture fixation is feasible, screw fixation may provide greater resistance to displacement of the coronoid compared with a suture lasso technique.
  
  
  CONCLUSIONS
  Clinical studies have reported a higher rate of failure after screw fixation compared with suture lasso fixation; however, this study demonstrated a greater stiffness and load to failure after screw fixation of type II coronoid fractures. Screw fixation may provide a stronger fixation construct for fractures of adequate size to support a screw. Further studies may be warranted to assess the importance of securing the anterior capsule to the coronoid tip when using a suture lasso construct because this may affect the stability of the elbow after fixation.
authors.affiliation: The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD.
authors.forename: Nicholas P
authors.initials: NP
authors.lastname: Iannuzzi
authors.affiliation: The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD.
authors.forename: Adrian G
authors.initials: AG
authors.lastname: Paez
authors.affiliation: The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD.
authors.forename: Brent G
authors.initials: BG
authors.lastname: Parks
authors.affiliation: The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD. Electronic address: anne.mattson@medstar.net.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Murphy
mesh_terms: D001696:Biomechanical Phenomena; D001863:Bone Screws; D002102:Cadaver; D004551:Elbow Joint / Q000601:surgery*; D019544:Equipment Failure Analysis; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D008422:Materials Testing; D013536:Suture Techniques; D014458:Ulna Fractures / Q000601:surgery*; D000092464:Elbow Injuries
keywords: Coronoid fractures; elbow instability; screw fixation; suture lasso fixation