Excellent results and low complication rate for anatomic polyaxial locking plates in comminuted proximal ulna fractures

Klug, Andreas; Gramlich, Yves; Buckup, Johannes; Wincheringer, Dennis; Hoffmann, Reinhard; Schmidt-Horlohé, Kay

doi:10.1016/j.jse.2018.05.032

Cited by 8 publications

(5 citation statements)

References 73 publications

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“…6 In human, medicine biomechanical and clinical studies show good results with the use of PLS. [7][8][9][10] For the veterinary PLS, no study so far has evaluated the differences in stability of screws placed in monoaxial compared with polyaxial fashion.…”

Section: Introductionmentioning

confidence: 99%

Mechanical Performance of a Polyaxial Locking Plate and the Influence of Screw Angulation in a Fracture Gap Model

Kaczmarek¹,

Bartkowiak

Schuenemann³

et al. 2019

Vet Comp Orthop Traumatol

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Objective The aim of this study was to compare the locking compression plate (LCP) with polyaxial locking system (PLS) using single cycle to failure 4-point bending test and to investigate the behaviour of PLS with screws inserted mono- and polyaxially using cyclic fatigue test in two bending directions. Materials and Methods Tests were performed on bone surrogates in a fracture gap model. The 3.5 LCP and 3.5 PLS plates were tested in single cycle to failure. The 3.5 PLS plates with mono- and polyaxial screws were compared in a cyclic fatigue tests in two orthogonal directions. For both experiments, micro-computed tomography (CT) scans were performed pre- and post-testing to investigate the connections between the screw head and the plate hole. Means of forces and cycles needed to failure were statistically compared. Results The PLS plates were on average 30% weaker than LCP plates. Mode of failure was plate bending in the single cycle to failure tests, and plate breakage in the cyclic fatigue tests. Neither screw breakage nor loss of the screw–plate interface occurred. Mono- and polyaxial constructs performed similarly when loaded in the same direction. Micro-CT revealed no additional internal cracks in the plates or screws after testing. It also showed for both PLS and LCP that there was only partial contact of the screw head with the plate hole. Clinical Relevance PLS offers a durable locking system, even when the screws are placed polyaxially. The weaker bending properties of the PLS compared with LCP should be considered during preoperative planning.

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Section: Introductionmentioning

confidence: 99%

Mechanical Performance of a Polyaxial Locking Plate and the Influence of Screw Angulation in a Fracture Gap Model

Kaczmarek¹,

Bartkowiak

Schuenemann³

et al. 2019

Vet Comp Orthop Traumatol

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“…This corresponds to an incidence of 1.15/10,000 person-years [1][2][3]. The short and medium term outcome of these fractures is generally reported as good [4][5][6][7][8][9][10][11][12][13][14], and the few existing long-term studies, one of which followed olecranon fractures for more than 10 years [15] and another for more than 15 years [2], support a durable outcome with time. No study has to our knowledge evaluated if the favorable long-term outcome accounts for all subtypes of olecranon fractures.…”

Section: Introductionmentioning

confidence: 93%

“…No study has to our knowledge evaluated if the favorable long-term outcome accounts for all subtypes of olecranon fractures. Most shortterm studies have only evaluated if the outcome differs after different type of surgeries [4][5][6][7][8][9][10][11][12][13][14]. On such study inferred that type of surgery are of more importance for the outcome than type of fracture [16], another study supporting this view when reporting no differences when comparing 78 consecutive patients with Mayo type IIA and IIB fractures [17].…”

Section: Introductionmentioning

confidence: 99%

Long-term outcomes after different types of Horne and Tanzer olecranon fractures

Hasserius

Hertervig

Josefsson

et al. 2020

Arch Orthop Trauma Surg

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Background It is unclear whether the outcomes differ after different Horne and Tanzer types of olecranon fractures. Materials and methods We evaluated 40 men and 55 women with isolated olecranon fractures, journals and radiographs from fracture event. The fractures were classified according to Horne and Tanzer. After a mean 19 years after the fracture events, we evaluated subjective, clinical and radiographic outcomes, using the uninjured arms as controls. Results 95% of patients with type I fractures reported, at follow-up, no differences between the elbows, 80% with type II fractures and 95% with type III fractures (p = 0.43). The three types of fractures had no differences in elbow range of motion or hand grip strength (when comparing injured and uninjured arms) and the proportions of individuals with radiographic elbow degenerative changes or joint space reduction were no different (all p > 0.05). Individuals with elbow degenerative changes had no inferior subjective elbow function compared to individuals with normal radiographs (p = 0.66), in contrast to those with joint space reduction compared to individuals with normal radiographs (p < 0.001). Interpretation All types of Horne and Tanzer olecranon fractures have favourable long-term outcome. Elbow joint space reduction is associated with inferior subjective elbow function while degenerative changes are not.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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“…PO has a high union rate (93%-100%) and high functional outcomes with an average Oxford Elbow Score of 44, MEPS range 89 to 99, ROM range 116°to 139°, quick-DASH range 13 to 17, DASH range 4.6 to 17, and Broberg-Morrey range 81 to 97. The implant removal in these studies ranged from 11% to 80% [63][64][65][66][67][68][69][70][71] . In a study of 321 olecranon fractures fixed with precontoured PO, 15.6% patients underwent implant removal 72 .…”

Section: Plate Osteosynthesismentioning

confidence: 99%

Olecranon Fractures

2023

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Olecranon fractures account for 10% of all elbow fractures and are more likely to result from a low-energy injury. A displaced fracture with a stable ulnohumeral joint (Mayo type 2) is the most common type of injury.» The management of an isolated olecranon fracture is based on patient factors (age, functional demand, and if medically fit to undergo surgery) and fracture characteristics including displacement, fragmentation, and elbow stability.» Nonoperative management can be successfully used in undisplaced fractures (Mayo type 1) and in displaced fractures (Mayo type 2) in frail patients with lower functional demands.» Patients with displaced olecranon fractures with a stable ulnohumeral joint without significant articular surface fragmentation (Mayo type 2A) can be managed with tension band wiring, plate osteosynthesis (PO), intramedullary fixation, or suture repair.» PO is advocated for multifragmentary fractures and fractures that are associated with ulnohumeral instability. It is essential to consider the variable anatomy of the proximal ulna during surgery.

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Excellent results and low complication rate for anatomic polyaxial locking plates in comminuted proximal ulna fractures

Cited by 8 publications

References 73 publications

Mechanical Performance of a Polyaxial Locking Plate and the Influence of Screw Angulation in a Fracture Gap Model

Mechanical Performance of a Polyaxial Locking Plate and the Influence of Screw Angulation in a Fracture Gap Model

Long-term outcomes after different types of Horne and Tanzer olecranon fractures

Olecranon Fractures

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