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Formerly Journal of Turgut Ozal Medical Center

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Angulated versus parallel headless cannulated screw fixation for type 1 capitellum fracture: A finite element study (p.2550-5)

Angulated versus parallel headless cannulated screw fixation for type 1 capitellum fracture: A finite element study (p.2550-5)

Nazmi Bulent Alp1, Tugba Efendigil2, Ozgur Demir3, Kerem Bilsel4, Onur Can Kalay5, Fatih Karpat5,
Oguz Dogan5, Gokhan Akdag6
1Clinic of Orthopedics and Traumatology, Bursa City Hospital, Bursa, Turkey
2Industry Engineering, Yildiz Teknik University, Istanbul, Turkey
3Naval Architecture and Marine Engineering, Yildiz Teknik University, Istanbul, Turkey
4Department of Orthopedics and Traumatology, Bezmialem Vakif University, Istanbul, Turkey
5Mechanical Engeneering, Uludag University, Bursa, Turkey
6Clinic of Orthopedics and Traumatology, Beylikduzu State Hospital, Istanbul, Turkey
Copyright © 2020 by authors and Annals of Medical Research Publishing Inc.


Aim: The unique shape and vascularization make capitellar fractures challenging to treat. In such cases, screw inclination is crucial to achieve stable fixation. In the present study, we aimed to evaluate the mechanical outcome of the different fixation angles formed by headless cannulated screws for treatment of type 1 capitellum fracture and compared interfragmentary displacement (IFD) using finite element analysis (FEA).
Material and Methods: In our study, three-dimensional finite element stress analysis was applied using the isotropic materials and static linear analysis. Stochastic screw inclination scenarios (Case 1, Case 2, Case 3, and Case 4) were generated, and perpendicular application of loads were simulated with magnitudes between 50 and 300 N on the elbow at angulations from 0º to 145º. The IFD in the four different screw inclination pairs were listed in the ANSYS general end processor. Relative IFD was calculated by measuring the total displacements in the X/Y/Z planes from 16 different points.
Results: According to the modeling, the magnitude of IFD was significantly different in terms of the force and the case factors under four altered forces. Analysis of displacement exhibited a significant difference in the force values of ‘100N/200N/300N’ and in the screw inclinations of Case 2 only. Although the interaction effect between the Force*Case was observed to be low, the most noticeable results were obtained from the “300N*Case 2.” pair compared to the others (p0.05).
Conclusion: Screws used for fracture fixation must maintain an anatomical correction, until it heals. Following a complex trauma such as a capitellar fracture, the elbow joint needs a stable fixation and early mobilization. Our FEA results suggest that the fixation via angled screws can achieve a more stable configuration than the paralleled ones.

Keywords: Finite element analysis; headless cannulated screws; interfragmentary displacement; Type 1 capitellum fracture


doi: 10.5455/annalsmedres.2020.06.555            



Annals of Medical Research is the scientific official journal of the Inonu University Faculty of Medicine. It is published monthly. The essential aim of the Annals of Medical Research is to publish scientifically high quality clinical and experimental research articles on fields of medicine which can contribute to the literature data. In addition, review articles, case reports, editorials, letters to the editors and manuscripts on publication ethics and medical history, which can contribute to the education and practices of physicians and health sector professionals within the scope of the journal’s target audience and which can increase the level of scientific communication between the authors and readers, are included in the scope of the journal.


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