0000000000039930
AUTHOR
Werner Sternstein
New intramedullary locking nail for olecranon fracture fixation--an in vitro biomechanical comparison with tension band wiring.
The aim of this study was to determine the difference in displacement of a newly designed intramedullary olecranon fracture fixation device compared with multifilament tension band wiring after 4 cycles and 300 cycles of dynamic continuous loading.In eight pairs of fresh-frozen cadaver ulnae, oblique olecranon fractures were created and stabilized using either newly designed intramedullary olecranon nail or multifilament tension band wiring. The specimens were then subjected to continuous dynamic loading (from 25 N to 200 N) using matched pairs of cadaveric upper extremities. The Wilcoxon test was used to determine statistical differences of the displacement in the fracture gap.After 4 cycl…
Dynamische Analyse von Osteosynthesen am Olecranon: ein in-vitro Vergleich zweier Osteosynthesesysteme / Dynamic analysis of olecranon osteosyntheses – an in vitro comparison of two osteosynthesis systems
INTRODUCTION The aim of the present study was to develop a test setup with continuous angle alteration to imitate elbow joint motion for the mechanical evaluation of tension band wiring and a newly designed intramedullary nail. MATERIALS AND METHODS The servo-pneumatical test stand worked with a rotational angle-adjusted and a linear force-adjusted engine. The fracture model was dynamically tested under cyclic loading imitating elbow joint motion. In total, 14 fresh cadaver upper extremities underwent olecranon fracture by means of transverse osteotomy and were assigned to two groups: tension band wiring and intramedullary nailing. There was a continuous angle alteration between 0 and 1000 …
Osteosynthese am proximalen Humerus mittels winkelstabiler Platte oder Doppelplatte: eine vergleichende biomechanische Untersuchung / Angle-fixed plate fixation or double-plate osteosynthesis in fractures of the proximal humerus: a biomechanical study
Internal fixation of fractures of the proximal humerus needs a high stability of fixation to avoid secondary loss of fixation. This is especially important in osteoporotic bone. In an experimental study, the biomechanical properties of the angle-fixed Philos plate (internal fixator) and a double-plate osteosynthesis using two one-third tubular plates were assessed. The fracture model was an unstable three-part fracture (AO type B2). Eight pairs of human cadaveric humeri were submitted to axial load and torque. In the first part of the study, it was assessed to which degree the original stiffness of the humeri could be restored after the osteotomy by the osteosynthesis procedure. Subsequentl…
Influence of formalin fixation on the biomechanical properties of human diaphyseal bone.
Owing to the lack of fresh human bones, formalin-fixed specimens are frequently used in biomechanical testing. However, formalin fixation is assumed to affect the biomechanical properties of bone. The aim of this study was to compare axial and torsional stiffness and bone mineral density in fresh and embalmed human bones. The subtrochanteric regions of 12 pairs of fresh human femora were randomised into two groups for paired comparison. After bone mineral density measurement, one group was preserved in 4% formalin. After 6 weeks, bone mineral density was remeasured and each specimen underwent axial and torsional loading. The formalin group showed significant higher stiffness values for tors…
Screw fixation of radial head fractures: Compression screw versus lag screw—A biomechanical comparison
Abstract Introduction Secondary loss of reduction and pseudarthrosis due to unstable fixation methods remain challenging problems of surgical stabilisation of radial head fractures. The purpose of our study was to determine whether the 3.0 mm Headless Compression Screw (HCS) provides superior stability to the standard 2.0 mm cortical screw (COS). Materials and methods Eight pairs of fresh frozen human cadaveric proximal radii were used for this paired comparison. A standardised Mason II-Fracture was created with a fragment size of 1/3 of the radial head's articular surface that was then stabilised either with two 3.0 mm HCS (Synthes) or two 2.0 mm COS (Synthes) according to a randomisation …
Dynamic biomechanical analysis of different olecranon fracture fixation devices--tension band wiring versus two intramedullary nail systems: an in-vitro cadaveric study.
Abstract Background. The aim of this study was to develop a test-setup with continuous angle alteration to imitate joint motion for the evaluation of 3 different olecranon fracture fixation devices. Methods. Twenty-one fresh cadaver upper extremities underwent olecranon fracture by the means of transverse osteotomy and received 3 different fixation systems. Group 1: Tension band wiring according to Weber. Group 2: XS-nail with 9 holes, all locked with 2 mm threaded K-wires. Group 3: Olecranon Nailing System with 90 mm length, locked with 2.7 mm screws, a variable angle locking hole for the proximal fragment and a proximal locking end cap. The servo-pneumatical test stand worked with a rotat…
Stability of radial head and neck fractures: a biomechanical study of six fixation constructs with consideration of three locking plates.
Open reduction and internal fixation of radial neck fractures can lead to secondary loss of reduction and nonunion due to insufficient stability. Nevertheless, there are only a few biomechanical studies about the stability achieved by different osteosynthesis constructs.Forty-eight formalin-fixed, human proximal radii were divided into 6 groups according to their bone density (measured by dual-energy x-ray absorptiometry). A 2.7-mm gap osteotomy was performed to simulate an unstable radial neck fracture, which was fixed with 3 nonlocking implants: a 2.4-mm T plate, a 2.4-mm blade plate, and 2.0-mm crossed screws, and 3 locking plates: a 2.0-mm LCP T plate, a 2.0-mm 6x2 grid plate, and a 2.0…
Sind winkelstabile Plattensysteme mit elastischen Eigenschaften für die Stabilisierung der Oberarmkopffraktur vorteilhaft? / Eine in-vitro biomechanische Untersuchung
AbstractWinkelstabile Platten werden mit zunehmender Häufigkeit zur Stabilisierung von Oberarmkopfbrüchen verwendet. Rigide Implantate führen bei osteoporotischen Knochenverhältnissen u. U. aber häufiger zum Versagen. Um den Effekt der Implantatelastizität zu beurteilen wurden in einer in-vitro Studie die biomechanischen Eigenschaften eines rigiden und eines elastischen winkelstabilen Plattensystems vergleichend analysiert. An 8 Humeruspaaren wurde eine instabile subkapitale Fraktur simuliert. Die Proben wurden axial- und torsions-belastet. Analysiert wurden die Steifigkeit, das Setzverhalten unter Dauerlast und die Versagensbelastung.Das elastische Plattensystem kennzeichnete sich durch ei…
Locking Reconstruction Double Plating of Distal Humeral Fractures: How Many Screws in the Distal Ulnar Column Segment in A3 Fracture Provide Superior Stability? A Comparative Biomechanical In Vitro Study
Objectives: Two 90-degree configurations of locking reconstruction plates with different numbers of screws in the distal ulnar column segment of distal extra-articular humeral fractures with metaphyseal comminution (A3) were biomechanically investigated. Methods: Eight pairs of fresh-frozen human humeri were used. For paired comparison, the humeri were divided into 2 randomized groups. In both groups, double-plate osteosyntheses with locking reconstruction plates were performed in 90-degree configurations. In group 1, the posteriorly placed radial column plate exceeded the capitellum and the ulnar column plate extended into the ulnar sulcus. The ulnar plate was molded around the medial epic…
Volar Fixed-Angle Plating of Distal Radius Fractures
The purpose of this biomechanical study was to determine whether a multidirectional fixed-angle plate with locking screws or with locking pegs in the distal fragment would optimize fixation of Orthopaedic Trauma Association (OTA) type A3 distal radius fractures.Eight pairs of fresh-frozen human distal radii were used. Extra-articular distal radius fractures were created and stabilized with a multidirectional volar fixed-angle plate. The radii were randomized into 2 matched-paired groups. The distal fragment in Group I was stabilized with 7 locking screws. The distal fragment in Group II was fixed with 7 locking pegs. The proximal fragment in both groups was fixed with 3 screws. The specimen…