Inducing pilon fractures in human cadaveric specimens depending on the injury mechanism: a fracture simulation

Ott, Nadine; Harbrecht, Andreas; Hackl, Michael; Leschinger, Tim; Knifka, Jutta; Müller, Lars Peter; Wegmann, Kilian

doi:10.1007/s00402-020-03538-9

Cited by 10 publications

(8 citation statements)

References 19 publications

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“…The choice of surgical incision is closely related to the pilon fracture pattern, and this opinion has become widely accepted by scholars [ 9 , 21 – 23 ]. Pilon fractures can be classified into five different patterns according to the ankle position at the initial time of injury: valgus, varus, plantarflexion, dorsiflexion, and neutral.…”

Section: Discussionmentioning

confidence: 99%

Medial malleolar window approach for varus-type tibial pilon fractures: a retrospective study

Yang

Shen

Zheng

et al. 2023

BMC Musculoskelet Disord

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Purpose Choosing a suitable surgical approach is crucial and challenging for type C pilon fractures. This article aims to explore the clinical efficacy of the medial malleolar window approach for varus-type tibial pilon fractures. Methods A retrospective analysis was conducted on 38 patients with type C varus-type pilon fractures treated between May 2018 and June 2021. In total, 16 cases underwent surgical treatment through the medial malleolar window approach and 22 cases were treated with the traditional anteromedial approach combined with a posterior approach. The operation time, hospitalization time, fracture healing time, the American Orthopedic Foot and Ankle score, Visual Analogue Scale, and complications were recorded to comprehensively evaluate the clinical efficacy of the technique. Fracture reduction quality was evaluated using the criteria proposed by Burwell and Charnley. Results All patients were followed up. No patients presented delayed union or nonunion. Compared with the conventional approach, the medial malleolar window approach had the advantage of better clinical effect recovery and better fracture reduction (P < 0.05). Meanwhile, the medial malleolar window approach had a shorter operation time, although the statistics suggest no significant difference with the control group. No implant exposure or infection occurred. There was good wound healing at two weeks after surgery in all but two cases. Local wound edge necrosis developed in one case in the medial malleolar window approach group, and the wound could not be closed at one stage in another case in the conventional group because of excessive tension, requiring secondary closure. Conclusion The medial malleolar window approach provides excellent exposure to type C pilon fractures, allowing for satisfactory fracture reduction and functional rehabilitation. The medial window approach is recommended for varus-type pilon fractures, which can effectively avoid a posterior incision and reduce the operation time.

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Section: Discussionmentioning

confidence: 99%

Medial malleolar window approach for varus-type tibial pilon fractures: a retrospective study

Yang

Shen

Zheng

et al. 2023

BMC Musculoskelet Disord

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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%

“…A feedback survey of a cadaver workshop to improve the operation skills for distal radius fractures received an excellent feedback from the participants [8]. With a drop test bench, they also managed to fracture anatomical specimens for different body sides including the distal humerus and the proximal forearm [7][8][9][10][11]. An alternative setup to fracture creation with a drop test bench could be a setup in a material testing machine.…”

Section: Introductionmentioning

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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“…El uso de especímenes con patrones de fractura reales permitiría condiciones de entrenamiento realistas. [3][4][5][6][7][8] Por lo tanto, el objetivo del presente estudio fue diseñar un método estandarizado y el uso de una máquina para simular fracturas diafisiarias transversas/oblicuas, con el objetivo de obtener patrones de fractura para cursos de educación quirúrgica. La ventaja sería un curso realista y una experiencia de aprendizaje mejorada.…”

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Fracturas diafisiarias transversas/oblicuas: un método para simular fracturas reales para la educación quirúrgica

Contreras¹,

Liendo²,

Marinis³

et al. 2022

Revista Latinoamericana De Simulación Clínica

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INTRODUCCIÓNL a simulación es una herramienta clave en la educación profesional de habilidades quirúrgicas. El entrenamiento de los traumatólogos es complejo, lleva mucho tiempo y requiere recursos financie-ros, ya que además de conferencias y elementos teóricos, también se deben enseñar habilidades y destrezas manuales. 1 Además, no sólo los futuros traumatólogos necesitan educación, sino que también los que ya terminaron su formación y deben ser introducidos en técnicas y nuevos implantes. 2 Ideas Innovadoras Clínica Simulación

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Inducing pilon fractures in human cadaveric specimens depending on the injury mechanism: a fracture simulation

Cited by 10 publications

References 19 publications

Medial malleolar window approach for varus-type tibial pilon fractures: a retrospective study

Medial malleolar window approach for varus-type tibial pilon fractures: a retrospective study

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

Fracturas diafisiarias transversas/oblicuas: un método para simular fracturas reales para la educación quirúrgica

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