Comminuted olecranon fractures: biomechanical testing of locked versus minifragment non-locked plate fixation.
Arch Orthop Trauma Surg
; 137(9): 1173-1179, 2017 Sep.
Article
en En
| MEDLINE
| ID: mdl-28634743
ABSTRACT
INTRODUCTION:
Open reduction and internal fixation has long been accepted as optimal treatment for displaced olecranon fractures based on poor results seen with conservative management. With the presence of comminution, tension-band wiring constructs are contraindicated due to tendency to compress through fragments, thereby shortening the articular segment. Therefore, plate fixation is typically employed. Our hypothesis was that in a comminuted fracture model, 2.7 mm reconstruction plating without locking screws will perform equally to 3.5 mm locked plating in terms of fracture displacement and rotation (shear). MATERIALS ANDMETHODS:
A three-part comminuted olecranon fracture pattern was created in nine matched pairs of cadaveric specimen using an oscillating saw in standardized, reproducible fashion. Each matched pair was then randomized to receive either 2.7 mm reconstruction plating or 3.5 mm proximal ulna locked plating. Random allocation software was used to assign the 2.7 mm plate construct to either the right or left side of each pair with the contralateral receiving the 3.5 mm plate construct. Specimens were cyclically loaded simulating passive range of motion exercises commonly performed during rehabilitation. Displacement and rotation in relation to the long axis of the ulna were measured through motion capture. Fragment gapping and rotation was quantified following 100 cycles at 10 N and again following 100 cycles at 500 N.RESULTS:
No significant differences were detected between the 2.7 and 3.5 mm plates in fracture rotation or gapping following loads at 10 N (0.5° and 0.7°; 0.6 and 1.2 mm; respectively; p > 0.05) or 500 N (2.3° and 1.6°; 3.8 and 3.1 mm; respectively; p > 0.05) loading. Fragment rotation and gapping were positively correlated within each plate construct (R 2 > 0.445; p < 0.05).CONCLUSIONS:
2.7 mm plating is an alternative to 3.5 mm locked plating with decreased plate prominence without significantly sacrificing displacement and rotational control. This is beneficial in fracture patterns where the traditional dorsal plating does not offer optimal screw trajectory.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Fracturas del Cúbito
/
Placas Óseas
/
Olécranon
/
Fijación Interna de Fracturas
Tipo de estudio:
Clinical_trials
Límite:
Humans
Idioma:
En
Revista:
Arch Orthop Trauma Surg
Año:
2017
Tipo del documento:
Article
País de afiliación:
Estados Unidos