Olecranon fracture fixation with a new implant
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Olecranon fracture fixation with a new implant : biomechanical and clinical considerations. / Koslowsky, Thomas C; Mader, Konrad; Dargel, Jens; Schadt, Ruediger; Koebke, Juergen; Pennig, Dietmar.
In: INJURY, Vol. 40, No. 6, 06.2009, p. 618-24.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Olecranon fracture fixation with a new implant
T2 - biomechanical and clinical considerations
AU - Koslowsky, Thomas C
AU - Mader, Konrad
AU - Dargel, Jens
AU - Schadt, Ruediger
AU - Koebke, Juergen
AU - Pennig, Dietmar
PY - 2009/6
Y1 - 2009/6
N2 - UNLABELLED: This study aims to describe the first clinical results in the treatment of dislocated olecranon fractures with 2.2-mm, fine-threaded wires with a washer. Furthermore, in the second part of the article, the stability of these new implants has been compared to standard tension band wiring in a sawbone model.PATIENTS: The radiological and clinical outcomes in 24 patients (mean age: 53.6 years) with 24 isolated Mayo type I and II fractures of the olecranon were evaluated in a prospective study after open reduction and internal fixation (ORIF) with a new fixation device (FFS; Orthofix). The quality of reduction with the implementation of 24 FFS constructions was compared with 24 tension band-wiring procedures performed by six different surgeons in a standard sawbone Mayo type IIa fracture model. Stability was tested in all constructs using a single cycle load to failure protocol (group I), cyclic loading for 300 cycles between 10 and 500 N (group II) and incremental sinusoidal loading from 10 to 200 N with an incremental increase of 10 N per cycle (group III) in a laboratory study.RESULTS: The Morrey elbow score was excellent in 23 patients and good in one patient, with mean DASH score of 1.6. No implant migration, secondary dislocation or nonunion was observed. In the sawbone model, the quality of reduction was the same with the FFS implants compared to the tension band wiring in the sawbone model. Here, bending moments in all three groups showed no significant difference, whereas displacement at failure was significantly greater in the tension band-wiring group at a single cycle load (p=0.017).CONCLUSION: Clinical results were comparable to tension band wiring and stability of the implants in the sawbone model was the same; thus, we conclude that the FFS technique can serve as an alternative treatment option for isolated olecranon fractures.
AB - UNLABELLED: This study aims to describe the first clinical results in the treatment of dislocated olecranon fractures with 2.2-mm, fine-threaded wires with a washer. Furthermore, in the second part of the article, the stability of these new implants has been compared to standard tension band wiring in a sawbone model.PATIENTS: The radiological and clinical outcomes in 24 patients (mean age: 53.6 years) with 24 isolated Mayo type I and II fractures of the olecranon were evaluated in a prospective study after open reduction and internal fixation (ORIF) with a new fixation device (FFS; Orthofix). The quality of reduction with the implementation of 24 FFS constructions was compared with 24 tension band-wiring procedures performed by six different surgeons in a standard sawbone Mayo type IIa fracture model. Stability was tested in all constructs using a single cycle load to failure protocol (group I), cyclic loading for 300 cycles between 10 and 500 N (group II) and incremental sinusoidal loading from 10 to 200 N with an incremental increase of 10 N per cycle (group III) in a laboratory study.RESULTS: The Morrey elbow score was excellent in 23 patients and good in one patient, with mean DASH score of 1.6. No implant migration, secondary dislocation or nonunion was observed. In the sawbone model, the quality of reduction was the same with the FFS implants compared to the tension band wiring in the sawbone model. Here, bending moments in all three groups showed no significant difference, whereas displacement at failure was significantly greater in the tension band-wiring group at a single cycle load (p=0.017).CONCLUSION: Clinical results were comparable to tension band wiring and stability of the implants in the sawbone model was the same; thus, we conclude that the FFS technique can serve as an alternative treatment option for isolated olecranon fractures.
KW - Biomechanical Phenomena
KW - Bone Wires
KW - Elbow Joint
KW - Female
KW - Fracture Fixation, Internal
KW - Humans
KW - Joint Dislocations
KW - Male
KW - Materials Testing
KW - Middle Aged
KW - Olecranon Process
KW - Prosthesis Failure
KW - Radiography
KW - Range of Motion, Articular
KW - Stress, Mechanical
KW - Tensile Strength
KW - Time Factors
KW - Treatment Outcome
KW - Ulna Fractures
KW - Journal Article
KW - Randomized Controlled Trial
KW - Research Support, Non-U.S. Gov't
U2 - 10.1016/j.injury.2009.01.129
DO - 10.1016/j.injury.2009.01.129
M3 - SCORING: Journal article
C2 - 19394014
VL - 40
SP - 618
EP - 624
JO - INJURY
JF - INJURY
SN - 0020-1383
IS - 6
ER -