Michael Hackl1, Katharina Mayer2, Mareike Weber2, Manfred Staat2, Roger van Riet3, Klaus Josef Burkhart4, Lars Peter Müller5, Kilian Wegmann5. 1. Center for Orthopedic and Trauma Surgery, University Medical Center of Cologne, Cologne, Germany; Cologne Center for Musculoskeletal Biomechanics, Medical Faculty, Cologne, Germany; Institute of Anatomy I, University of Cologne, Cologne, Germany. Electronic address: michaelhackl@live.de. 2. Institute of Bioengineering, Aachen University of Applied Sciences, Jülich, Germany. 3. Department of Orthopedic Surgery, Monica Hospital, Antwerp, Belgium. 4. Department of Shoulder and Elbow Surgery, ARCUS Sportklinik, Pforzheim, Germany. 5. Center for Orthopedic and Trauma Surgery, University Medical Center of Cologne, Cologne, Germany; Cologne Center for Musculoskeletal Biomechanics, Medical Faculty, Cologne, Germany.
Abstract
PURPOSE: Double plating has been promoted, in recent years, as an alternative treatment method for proximal ulna fractures. This study aimed to compare the biomechanical properties of double-plate osteosynthesis with posterior plate fixation using a novel investigational design utilizing a 3-dimensional camera system to analyze fracture micromotion. METHODS: Fourteen fresh-frozen specimens were available for this study. Mayo type IIA fractures of the olecranon were created and internal fixation was performed with either an angular stable posterior plate or angular stable double plates. Fracture micromotion was evaluated by means of digital image correlation with a 3-dimensional camera system before and after dynamic cyclic loading from 15° to 90° of elbow flexion with a pulling force of 25 N to 80 N. RESULTS: Micromotion of fragments was less pronounced in double-plate osteosynthesis when compared with single plates before and after cyclic loading. However, overall results were similar. Two of the single plates failed during cyclic loading but there were no failures in the double plates. CONCLUSIONS: This biomechanical analysis shows that single and double plating results in comparable stability of fixation. Although the double-plating technique tends to provide more stable fixation, relevant differences were not observed. CLINICAL RELEVANCE: Double plating potentially represents an efficient option for fixation of proximal ulna fractures. It could decrease the risk of soft tissue complications owing to their low profile and the superior soft tissue coverage.
PURPOSE: Double plating has been promoted, in recent years, as an alternative treatment method for proximal ulna fractures. This study aimed to compare the biomechanical properties of double-plate osteosynthesis with posterior plate fixation using a novel investigational design utilizing a 3-dimensional camera system to analyze fracture micromotion. METHODS: Fourteen fresh-frozen specimens were available for this study. Mayo type IIA fractures of the olecranon were created and internal fixation was performed with either an angular stable posterior plate or angular stable double plates. Fracture micromotion was evaluated by means of digital image correlation with a 3-dimensional camera system before and after dynamic cyclic loading from 15° to 90° of elbow flexion with a pulling force of 25 N to 80 N. RESULTS: Micromotion of fragments was less pronounced in double-plate osteosynthesis when compared with single plates before and after cyclic loading. However, overall results were similar. Two of the single plates failed during cyclic loading but there were no failures in the double plates. CONCLUSIONS: This biomechanical analysis shows that single and double plating results in comparable stability of fixation. Although the double-plating technique tends to provide more stable fixation, relevant differences were not observed. CLINICAL RELEVANCE: Double plating potentially represents an efficient option for fixation of proximal ulna fractures. It could decrease the risk of soft tissue complications owing to their low profile and the superior soft tissue coverage.
Authors: Hongfei Qi; Zhong Li; Shuai Ji; Ming Li; Yao Lu; Teng Ma; Bing Du; Qiang Huang; Kun Zhang; Yanling Yang Journal: BMC Musculoskelet Disord Date: 2022-06-01 Impact factor: 2.562
Authors: Stefanie Hoelscher-Doht; A-M Kladny; M M Paul; L Eden; M Buesse; R H Meffert Journal: Arch Orthop Trauma Surg Date: 2020-05-16 Impact factor: 3.067