Monteggia-Frakturen und Monteggia-like Lesions

Mütze, Maria; Hepp, Pierre; Josten, Christoph

doi:10.1055/a-0968-9383

Cited by 2 publications

(1 citation statement)

References 33 publications

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“…Fractures of the proximal ulna in combination with proximal radioulnar dissociation and dislocation of the radial head are referred to as Monteggia fractures. Monteggia injuries occur with an incidence of 2–5% of all forearm injuries [ 21 ]. Among adults, Monteggia fractures most commonly arise in young males due to high-energy traumata, such as falls from great heights, sports injuries, or car accidents, whereas fractures in elderly females tend to be caused by low-energy traumata [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

“Mother and baby plate”: a strategy to improve stability in proximal fractures of the ulna

Hoelscher-Doht,

Zufall,

Heilig

et al. 2023

Arch Orthop Trauma Surg

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Introduction Proximal ulna fractures with a large zone of comminution, such as in the context of Monteggia injuries, require mechanically strong osteosyntheses as they occur in regions with high physiological joint load. Consequently, implant failure and pseudarthrosis are critical and devastating complications, especially with the background of mainly young patients being affected. An effective solution could be provided by adding a small second plate 90° angulated to the standard dorsal plate in the area of non-union. Thus, this study investigates whether, from a biomechanical point of view, the use of such a mini or baby plate is worthwhile. Materials and methods Comminuted fractures distal to the coronoid process, equivalent to Jupiter type IIb fractures, are generated on artificial Sawbones® of the ulna and stabilized using two different plate osteosyntheses: in the first group, a dorsal locking compression olecranon plate is used (LCP group). In the second group, a small, ulnar 5-hole olecranon plate is added as a baby plate in addition to the mother plate at the level of the fracture zone (MBP group). Dynamic biomechanical loading in degrees of flexion from 0° to 90° is carried out to determine yield load, stiffness, displacement, and changes in fracture gap width as well as bending of the dorsal plate. Results The “mother-baby-plate” osteosynthesis had a significantly higher yield load (p < 0.01) and stiffness (p = 0.01) than the LCP group. This correlates with the increased movement of the proximal fracture element during cyclic testing for the LCP group compared to the MBP group as measured by an optical metrology system. Conclusions Here, we show evidence that the addition of a small plate to the standard plate is highly effective in increasing the biomechanical stability in severe fractures equivalent to Jupiter type IIb. As it hopefully minimizes complications like pseudarthrosis and implant failure and as the additional preparatory effort leading to compromised blood supply is regarded to be negligible, this justifies and highly advises the use of a mother–baby-plate system.

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Section: Discussionmentioning

confidence: 99%