Axel Marcoin1, David Eichler2, Jean-François Kempf3, Philippe Clavert4. 1. CHU Maison Blanche, 45 Rue Cognacq Jay, 51092, Reims, France. 2. CHU Strasbourg, Strasbourg, France. 3. Shoulder and Elbow Department, CCOM-CHU Strasbourg, 10 avenue Achille Baumann, 67400, Illkirch-Graffenstaden, France. 4. Laboratoire iCube-GEBOAS, CNRS UMR 7357, Equipe 12 Matériaux Multi-échelles et Biomécanique, Institut d'Anatomie Normale, Faculté de médecine, 67085, Strasbourg, France. philippe.clavert@chru-strasbourg.fr.
Abstract
INTRODUCTION: Working hypothesis: The distal humeral bone density influences supracondylar fracture threshold. The aim of this study was first to develop a reproducible model of intra-articular distal humeral fractures and second to establish a relationship between bone mineral density (BMD) and the fracture threshold of the humerus. MATERIALS AND METHODS: An original model of the fracture was developed using ten sawbones. After obtaining a reproducible and clinically relevant fracture model, we tested 21 cadaveric distal humeri for which the BMD was known with a stainless-steel custom-made proximal ulna jig. Fractures were created using a servo hydraulic-testing machine in axial compression to simulate a fall onto an outstretched hand. Fracture lines, load to failure, and rigidity of the bone were recorded based on the stress-strain curves. RESULTS: The fracture generation was reliable, reproducible, and clinically relevant (type B2). A significant correlation between the BMD and the fracture threshold was found. Mean threshold was 901.86 N/m2. Mean distal humerus BMD was 0.9097 g/cm2 (r = 0.7321). CONCLUSIONS: We developed a reproducible articular fracture of the distal humerus model and found a correlation between the fracture threshold and bone mineral density.
INTRODUCTION: Working hypothesis: The distal humeral bone density influences supracondylar fracture threshold. The aim of this study was first to develop a reproducible model of intra-articular distal humeral fractures and second to establish a relationship between bone mineral density (BMD) and the fracture threshold of the humerus. MATERIALS AND METHODS: An original model of the fracture was developed using ten sawbones. After obtaining a reproducible and clinically relevant fracture model, we tested 21 cadaveric distal humeri for which the BMD was known with a stainless-steel custom-made proximal ulna jig. Fractures were created using a servo hydraulic-testing machine in axial compression to simulate a fall onto an outstretched hand. Fracture lines, load to failure, and rigidity of the bone were recorded based on the stress-strain curves. RESULTS: The fracture generation was reliable, reproducible, and clinically relevant (type B2). A significant correlation between the BMD and the fracture threshold was found. Mean threshold was 901.86 N/m2. Mean distal humerus BMD was 0.9097 g/cm2 (r = 0.7321). CONCLUSIONS: We developed a reproducible articular fracture of the distal humerus model and found a correlation between the fracture threshold and bone mineral density.
Entities:
Keywords:
Bone mechanical properties; Bone mineral density; Distal humerus fracture; Fracture risk; Fracture threshold
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