Arvind von Keudell1,2,3, Amir Kachooei4, Amin Mohamadi1, Sharri J Mortensen1, Stephen Okajima1, Jonathan Egan1, MichaelJ Weaver2,3, George S M Dyer2,3, Ara Nazarian1,3. 1. Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. 2. Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 3. Harvard Orthopaedic Trauma Initiative, Harvard Medical School, Boston, MA, USA. 4. Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract
INTRODUCTION: The aim of the study is to compare three different fixation techniques for transverse olecranon repair in cadaveric osteoporotic bone: (1) current recommended AO tension band technique with K-wire fixation; (2) Suture anchor fixation and (3) Polyester suture fixation. METHODS: Evaluated with bone densitometry, 7 osteoporotic human elbow specimens were included in the study. A transverse olecranon fracture was reduced anatomically and were fixated first using a K-wire tension band technique, second using two suture anchors, and third using polyester suture. Static simulations of the kinetics associated with active range of motion (AROM) and push up from a chair exercises were performed with cyclic loading using Instron hydraulic testing apparatus. Fracture displacement was measured using videographic analysis. Failure was defined as 2 mm fracture displacement. RESULTS: The biomechanical analysis found no statistical difference in displacements between the three fixation methods when testing AROM. In simulated push-up exercises, polyester suture fixation failed after 17 cycles and had significantly higher displacement compared to the other two methods. No difference between the K-Wire fixation versus Suture anchor fixation was observed, p = 0.162. CONCLUSION: Suture anchor fixation might be a viable surgical treatment option for osteoporotic transverse elbow fractures in geriatric patients.
INTRODUCTION: The aim of the study is to compare three different fixation techniques for transverse olecranon repair in cadaveric osteoporotic bone: (1) current recommended AO tension band technique with K-wire fixation; (2) Suture anchor fixation and (3) Polyester suture fixation. METHODS: Evaluated with bone densitometry, 7 osteoporotic human elbow specimens were included in the study. A transverse olecranon fracture was reduced anatomically and were fixated first using a K-wire tension band technique, second using two suture anchors, and third using polyester suture. Static simulations of the kinetics associated with active range of motion (AROM) and push up from a chair exercises were performed with cyclic loading using Instron hydraulic testing apparatus. Fracture displacement was measured using videographic analysis. Failure was defined as 2 mm fracture displacement. RESULTS: The biomechanical analysis found no statistical difference in displacements between the three fixation methods when testing AROM. In simulated push-up exercises, polyester suture fixation failed after 17 cycles and had significantly higher displacement compared to the other two methods. No difference between the K-Wire fixation versus Suture anchor fixation was observed, p = 0.162. CONCLUSION: Suture anchor fixation might be a viable surgical treatment option for osteoporotic transverse elbow fractures in geriatric patients.
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