Comminuted olecranon fracture fixation with pre-contoured plate: Comparison of composite and cadaver bones

Hamilton, David A.; Reilly, Danielle; Wipf, Felix; Kamineni, Srinath

doi:10.5312/wjo.v6.i9.705

Cited by 10 publications

(2 citation statements)

References 22 publications

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“…Initially, forearm fractures were created with manual hydraulic devices, followed by manual fracture creation in a material testing machine up to the current setup with a simulated impact with a servo-hydraulic material machine. In the literature, fracture creation in anatomical specimens is described either by dropping a dead weight or by the use of a material testing machine [7,[9][10][11][25][26][27]. In drop dead weight, fracture generation specimens are subjected to an impact with a predefined amount of energy with an optional limit of the displacement, while in material testing machines, specimens are subjected to an impact with a predefined displacements or force with an unlimited amount of energy.…”

Section: Discussionmentioning

confidence: 99%

Standardized fracture creation in the distal humerus and the olecranon for surgical training and biomechanical testing

Schmoelz

Zierleyn

Hörmann

et al. 2022

Arch Orthop Trauma Surg

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Introduction Surgical training and biomechanical testing require models that realistically represent the in vivo injury condition. The aim of this work was to develop and test a method for the generation of distal humerus fractures and olecranon fractures in human specimens, while preserving the soft tissue envelope. Methods Twenty-one cadaveric upper extremity specimens (7 female, 14 male) were used. Two different experimental setups were developed, one to generate distal humerus fractures and one to generate olecranon fractures. Specimens were placed in a material testing machine and fractured with a predefined displacement. The force required for fracturing and the corresponding displacement were recorded and the induced energy was derived of the force–displacement graphs. After fracturing, CT imaging was performed and fractures were classified according to the AO classification. Results Eleven distal humerus fractures and 10 olecranon fractures with intact soft tissue envelope could be created. Distal humerus fractures were classified as AO type C (n = 9) and as type B (n = 2), all olecranon fractures were classified as AO type B (n = 10). Distal humerus fractures required significantly more load than olecranon fractures (6077 N ± 1583 vs 4136 N ± 2368, p = 0.038) and absorbed more energy until fracture than olecranon fractures (17.8 J ± 9.1 vs 11.7 J ± 7.6, p = 0.11), while the displacement at fracture was similar (5.8 mm ± 1.6 vs 5.9 mm ± 3.1, p = 0.89). Conclusion The experimental setups are suitable for generating olecranon fractures and distal humerus fractures with intact soft tissue mantle for surgical training and biomechanical testing.

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Section: Discussionmentioning

confidence: 99%

Standardized fracture creation in the distal humerus and the olecranon for surgical training and biomechanical testing

Schmoelz

Zierleyn

Hörmann

et al. 2022

Arch Orthop Trauma Surg

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“…The test setup was modified based on methods in previous studies. [ 14 , 15 , 19 – 22 ] The mechanical testing machine was an Instron E3000 (Instron Engineering Corporation, Norwood, MA). All specimens were fixed on a hollow cylindrical fixture customized for this study (Fig.…”

Section: Methodsmentioning

confidence: 99%

Biomechanical comparison between double-plate fixation and posterior plate fixation for comminuted olecranon fracture using two triceps screws in synthetic bone model

et al. 2022

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Background: Although preventing triceps fragment displacement is essential for treating an olecranon fracture, we frequently encounter situations in which only a few screws can be fixed to the triceps fragment. The aim of this study was to compare the stability of double-plate fixation and posterior plate fixation for olecranon fractures when the triceps fragment was small and only 2 screws could be inserted. Methods: A composite ulna model was used to simulate olecranon fracture. Four groups were formed consisting of double-plate and posterior plates with cortical and locking screws. The cyclic loading test was conducted for 500 cyclic loads of 5 to 50 N on a specimen to measure micromotion and displacement of the gap caused by light exercise. The load-to-failure test was performed by applying a load until fixation loss, defined as when the fracture gap increased by 2 mm or more or catastrophic failure occurred, to measure the maximum load. Results: Eight samples per group were tested through the pilot study. All groups were stable with a micromotion of <0.5 mm. However, the mean micromotion showed significant differences between the 4 groups ( P < .001, Table 1 Table 1 Mean gapping and displacement in the cyclic loading test. Displacement after the test Group Gapping during the test (range) Anterior cortex (range) Posterior cortex (range) Double-cortical 0.42 ± 0.11 (0.25–0.58) ∗ 0.02 ± 0.18 (−0.78–0.31) 0.14 ± 0.14 (−0.13–0.16) † Double-locking 0.17 ± 0.03 (0.12–0.21) ∗ 0.05 ± 0.10 (−0.16–0.16) 0.08 ± 0.14 (−0.17–0.11) Posterior-cortical 0.09 ± 0.02 (0.05–0.12) ∗ 0.03 ± 0.13 (−0.37–0.22) 0.03 ± 0.19 (−0.14–0.28) Posterior-locking 0.12 ± 0.04 (0.07–0.17) ∗ 0.04 ± 0.10 (−0.12–0.22) −0.03 ± 0.22 (−0.44–0.20) ). In the mean micromotion during exercise, posterior plating with cortical screws was the most stable (0.09 ± 0.02 mm) while double-plating with cortical screws was the most unstable (0.42 ± 0.11 mm). At the maximum load, posterior plating with locking screws was the strongest (205.3 ± 2.8 N) while double-plating with cortical screws was the weakest (143.3 ± 27.1 N). There was no significant difference in displacement after light exercise between the groups. Conclusions: This study...

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Implants for Olecranon and Coronoid Fractures

Dirckx,

Jukes,

Phadnis

2022

Handbook of Orthopaedic Trauma Implantology

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Comminuted olecranon fracture fixation with pre-contoured plate: Comparison of composite and cadaver bones

Abstract: The pre-contoured olecranon plate provides adequate fixation to withstand physiologic force in a composite bone and cadaveric comminuted olecranon fracture model.

Cited by 10 publications

References 22 publications

Standardized fracture creation in the distal humerus and the olecranon for surgical training and biomechanical testing

Standardized fracture creation in the distal humerus and the olecranon for surgical training and biomechanical testing

Biomechanical comparison between double-plate fixation and posterior plate fixation for comminuted olecranon fracture using two triceps screws in synthetic bone model

Implants for Olecranon and Coronoid Fractures

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