Comminuted olecranon fracture fixation with pre-contoured plate:Comparison of composite and cadaver bones  

作　　者：David A Hamilton Jr Danielle Reilly Felix Wipf Srinath Kamineni 

机构地区：[1]Elbow Shoulder Research Centre,Department of Orthopaedic Surgery and Sports Medicine,University of Kentucky [2]Stryker Trauma AG,CH-2545 Selzach,Switzerland

出　　处：《World Journal of Orthopedics》2015年第9期705-711,共7页世界骨科杂志（英文版）

摘　　要：AIM: To determine whether use of a precontoured olecranon plate provides adequate fixation to withstand supraphysiologic force in a comminuted olecranon fracture model.METHODS: Five samples of fourth generation composite bones and five samples of fresh frozen human cadaveric left ulnae were utilized for this study. The cadaveric specimens underwent dual-energy X-ray absorptiometry(DEXA) scanning to quantify the bone quality. The composite and cadaveric bones were prepared by creating a comminuted olecranon fracture and fixed with a pre-contoured olecranon plate with locking screws. Construct stiffness and failure load were measured by subjecting specimens to cantilever bending moments until failure. Fracture site motion was measured with differential variable resistance transducer spanning the fracture. Statistical analysis was performed with two-tailed Mann-Whitney-U test with Monte Carlo Exact test.RESULTS: There was a significant difference in fixation stiffness and strength between the composite bones and human cadaver bones. Failure modes differed in cadaveric and composite specimens. The load to failure for the composite bones(n = 5) and human cadaver bones(n = 5) specimens were 10.67 nm(range 9.40-11.91 nm) and 13.05 nm(range 12.59-15.38 nm) respectively. This difference was statistically significant(P ? 0.007, 97% power). Median stiffness for composite bones and human cadaver bones specimens were 5.69 nm/mm(range 4.69-6.80 nm/mm) and 7.55 nm/mm(range 6.31-7.72 nm/mm). There was a significant difference for stiffness(P ? 0.033, 79% power) between composite bones and cadaveric bones. No correlation was found between the DEXA results and stiffness. All cadaveric specimens withstood the physiologic load anticipated postoperatively. Catastrophic failure occurred in all composite specimens. All failures resulted from composite bone failure at the distal screw site and not hardware failure. There were no catastrophic fracture failures in the cadaveric specimens. Failure of 4/5 cadaveric specimens was defined wheAIM: To determine whether use of a precontoured olecranon plate provides adequate fixation to withstand supraphysiologic force in a comminuted olecranon fracture model.METHODS: Five samples of fourth generation composite bones and five samples of fresh frozen human cadaveric left ulnae were utilized for this study. The cadaveric specimens underwent dual-energy X-ray absorptiometry(DEXA) scanning to quantify the bone quality. The composite and cadaveric bones were prepared by creating a comminuted olecranon fracture and fixed with a pre-contoured olecranon plate with locking screws. Construct stiffness and failure load were measured by subjecting specimens to cantilever bending moments until failure. Fracture site motion was measured with differential variable resistance transducer spanning the fracture. Statistical analysis was performed with two-tailed Mann-Whitney-U test with Monte Carlo Exact test.RESULTS: There was a significant difference in fixation stiffness and strength between the composite bones and human cadaver bones. Failure modes differed in cadaveric and composite specimens. The load to failure for the composite bones(n = 5) and human cadaver bones(n = 5) specimens were 10.67 nm(range 9.40-11.91 nm) and 13.05 nm(range 12.59-15.38 nm) respectively. This difference was statistically significant(P ? 0.007, 97% power). Median stiffness for composite bones and human cadaver bones specimens were 5.69 nm/mm(range 4.69-6.80 nm/mm) and 7.55 nm/mm(range 6.31-7.72 nm/mm). There was a significant difference for stiffness(P ? 0.033, 79% power) between composite bones and cadaveric bones. No correlation was found between the DEXA results and stiffness. All cadaveric specimens withstood the physiologic load anticipated postoperatively. Catastrophic failure occurred in all composite specimens. All failures resulted from composite bone failure at the distal screw site and not hardware failure. There were no catastrophic fracture failures in the cadaveric specimens. Failure of 4/5 cadaveric specimens was defined whe

关 键 词：COMPOSITE bone Fracture Biomechanic CADAVERIC OLECRANON Precontoured PLATE 

分 类 号：R687.3[医药卫生—骨科学]