Anatomical fit of seven different palmar distal radius plates.

INTRODUCTION: The purpose of this study was to compare the anatomical fit of different, precontoured palmar distal radius plates. METHODS: The anatomical fit of seven different types of palmar distal radius plates [Königsee variable fixed-angle radius plate 7/3-hole, Königsee variable fixed-angle radius plate 5/3-hole (Allendorf, Germany), Medartis 2.5 Adaptive TriLock, Medartis 2.5 TriLock, Medartis 2.5 TriLock extraarticular, (Basel, Switzerland), Synthes VA-LCP distal two-column-radius, Synthes LCP extraarticular (Bettlach, Switzerland)] were investigated in 25 embalmed human cadaveric radii. An imprint of the space between the well-positioned plate and the distal radius was attained using a silicone mass and the maximum height of the silicone imprint was digitally measured. The mean maximum imprint height was compared between the seven plates using an analysis of variance with repeated measures and Bonferroni correction for multiple comparisons. RESULTS: The mean maximum distance between the plates and the radial cortex was <2 mm for all plates. The greatest difference was found with the Medartis Adaptive (1.99 ± 0.45 mm) and the least difference with the Synthes two-column (1.56 ± 0.76 mm), this difference being statistically significant (p = 0.005). CONCLUSION: Although there was no complete congruency between the plates and the radial cortex, all distal palmar radius plates investigated in this study presented a reasonable anatomical shape. The Synthes VA-LCP distal two-column-radius plate palmar showed the best anatomical fit. A low profile and optimized anatomical precontouring minimizes irritation of the surrounding soft tissues and should be considered with plate design and implant choice.

Combined iliac crest graft and short-scar pectoralis major flap for clavicular non-union reconstruction.

Recently, we reported defect coverage in the clavicular region with a scar-sparing pectoralis major flap. We successfully combine this flap with a clavicular reconstruction by an iliac bone graft for non-union now. We propose this reconstructive combination for cases of clavicular non-union with lack of soft tissue coverage.

Morphometric and biomechanical comparison of tendons used for interposition arthroplasty in carpometacarpal arthritis of the thumb.

PURPOSE: To identify the wrist tendon most effectively maintaining the trapezial space in interpositional arthroplasty in osteoarthritis of the carpometacarpal joint of the thumb. METHODS: The morphometrics of the os trapezium and the tendons of the flexor carpi radialis, extensor carpi radialis longus, and abductor pollicis longus were determined. The stiffness and compressive loading characteristics of the rolled-up tendons were compared to the os trapezium. RESULTS: No significant morphometric differences between the three tendons were found. The mass and volume of the trapezium was significantly larger when compared to the tendon balls. No significant differences in the compressive loading resistance were found between the tendons, but the mean stiffness was 85% lower when compared to the os trapezium. CONCLUSIONS: Neither tendon material approached the volume nor the stiffness provided by the os trapezium. Any tendon is considered to insufficiently maintain the trapezial space following trapeziectomy.

A technique to facilitate everting the patella in stiff or obese knees in total knee arthroplasty.

In many techniques for total knee arthroplasty, eversion of the patella is necessary. In stiff or obese knees, eversion is often difficult to perform. With the patella-holding clamp (used to cement the patellar component), it is possible to keep the patella in an everted position while the knee is being flexed.