A biomechanical evaluation of methods of distal humerus fracture fixation using locking compression plates versus conventional reconstruction plates.

Abstract:

OBJECTIVES:To examine the biomechanical behavior of 2 techniques of double-plate osteosynthesis for fractures of the adult distal humerus using conventional reconstruction plates and locking compression plates. DESIGN:Basic science study. SETTING:Experimental in vitro study. PATIENTS/PARTICIPANTS:Forty fresh-frozen human distal humeri specimens. INTERVENTION:Four matched groups with 10 humeri each, median age 74 years (46-95), were created using similar bone mineral density values. Two standard configurations of double-plate osteosynthesis (dorsal or 90 degrees configuration) with either conventional reconstruction plates or locking compression plates were studied for biomechanical properties of the constructs. A fracture model with a 5-mm supracondylar osteotomy gap simulating metaphyseal comminution (AO type 13-A3.3) was used. MAIN OUTCOME MEASUREMENT:Stiffness testing of the constructs in anterior/posterior bending, torsion, and axial compression loading. Evaluation of alterations of the bone-implant interface and failure patterns under cyclic loading and strength testing. RESULTS:The study demonstrates that primary stiffness in anterior/posterior bending and torsional loading is significantly increased by using locking compression plates in a 90 degrees configuration (P < 0.05) as compared with dorsally applied plates. The differences between the different plate types are insignificant if applied in the same configuration. It is demonstrated that none of the tested implants failed under cyclic loading within the number of cycles expected for 3 months of use. The bone-implant interface is less likely to fail during strength testing with locking compression plates. CONCLUSION:The biomechanical behavior of the osteosynthesis depends more on plate configuration than plate type. Advantages of locking compression plates are only significant if compared with dorsal plate application techniques. Nevertheless, locking compression plates are helpful supplementary tools for achieving primary stable fracture fixation. This might be of considerable clinical relevance in patients with diminished bone mineral quality or in the presence of metaphyseal comminution.

journal_name

J Orthop Trauma

authors

Korner J,Diederichs G,Arzdorf M,Lill H,Josten C,Schneider E,Linke B

doi

10.1097/00005131-200405000-00004

subject

Has Abstract

pub_date

2004-05-01 00:00:00

pages

286-93

issue

5

eissn

0890-5339

issn

1531-2291

pii

00005131-200405000-00004

journal_volume

18

pub_type

杂志文章
  • Split-Depressed Lateral Tibial Plateau Fractures: A Comparison of Augmented Percutaneous Screws Versus Augmented Plate and Screw Construct in a Cadaveric Model.

    abstract:OBJECTIVES:To compare the strength of fixation of percutaneous screw versus plate/screw fixation in a paired cadaver model of OTA 41-B3 (Schatzker type II) split-depression fractures of the lateral tibial plateau. METHODS:Six matched pairs of cadaveric knees were acquired. An OTA 41-B3 (Schatzker type II) split-depres...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001177

    authors: Bowles RJ,Chadayammuri V,Baldini T,Brecevich A,Mauffrey C

    更新日期:2018-07-01 00:00:00

  • Economic value of orthopaedic trauma: the (second to) bottom line.

    abstract:OBJECTIVES:We evaluated the economic aspects of an orthopaedic trauma section at a regional Level I, semi-academic community hospital. This study analyzes the economics of a dedicated hospital-based orthopaedic trauma program. METHODS:Institutional financial reports were analyzed for 2 time periods. In the pre-program...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e31816bae67

    authors: Ziran BH,Barrette-Grischow MK,Marucci K

    更新日期:2008-04-01 00:00:00

  • Navigated femoral nailing using noninvasive registration of the contralateral intact femur to restore anteversion. Technique and clinical use.

    abstract::The difficulty in assessing femoral rotation during intramedullary nailing is well-established. Navigation systems allow the surgeon to detect and set the version of the injured leg at the desired angle. We report the first cases of navigated femoral nailing using noninvasive registration of the contralateral uninjure...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e31812f69a9

    authors: Kendoff D,Citak M,Gardner MJ,Gösling T,Krettek C,Hüfner T

    更新日期:2007-11-01 00:00:00

  • Ulnar-styloid nonunion and partial rupture of extensor carpi ulnaris tendon: two case reports and review of the literature.

    abstract::Two unusual cases of symptomatic partial rupture of the extensor carpi ulnaris tendon associated with ulnar-styloid nonunion are described. Intraoperative findings suggested that the jagged surface of the distal ulna was the cause of flaying. In one case, debridement of the frayed extensor carpi ulnaris tendon and fix...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,评审

    doi:10.1097/00005131-200210000-00011

    authors: Kiyono Y,Nakatsuchi Y,Saitoh S

    更新日期:2002-10-01 00:00:00

  • Can the "turn-of-the-nut" method improve cortical screw fixation?

    abstract:OBJECTIVES:To determine the angular rotation that maximizes screw tension without sacrificing screw pullout force yet minimizing loss of screw purchase. METHODS:Three pairs of human humeri in each of the 3 groups (osteopenic, osteoporotic, and normal) underwent screw tension and pullout protocols. For screw tension, 3...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/01.bot.0000435631.71393.60

    authors: Thakkar SC,Langdale ER,Mears SC,Belkoff SM

    更新日期:2014-04-01 00:00:00

  • Reverse shoulder prosthesis for acute four-part fracture: tuberosity fixation using a horseshoe graft.

    abstract::Results of hemiarthroplasty for complex four-part proximal humerus fractures in the elderly have been unreliable. Although patients often achieve pain relief, return of above-shoulder level function can be challenging, because tuberosity nonunion, malunion, and/or resorption is quite common. The reverse shoulder repla...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e3181f22088

    authors: Levy JC,Badman B

    更新日期:2011-05-01 00:00:00

  • Anatomic Fixation of Supination External Rotation Type IV Equivalent Ankle Fractures.

    abstract:OBJECTIVES:To compare radiographic and clinical outcomes of supination external rotation type IV equivalent (SER IV E) ankle fractures (AO/OTA classification 44-B2.1) treated with transsyndesmotic screw fixation with those treated with deltoid and posterior inferior tibiofibular ligament (PITFL) repair. DESIGN:Case se...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000000318

    authors: Little MM,Berkes MB,Schottel PC,Garner MR,Lazaro LE,Birnbaum JF,Helfet DL,Lorich DG

    更新日期:2015-05-01 00:00:00

  • Amputations through the hind foot: a report of three cases using a modified Dwyer and Paul procedure.

    abstract::Salvage of limb length following oblique proximal foot amputations is presented. The technique, results, and follow-up of this procedure are described and compared with other standard procedures. A prospective study was done on 3 adolescents who presented consecutively during years 1999 and 2000. The salvage procedure...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/01.bot.0000164168.94365.49

    authors: Dwyer AJ,Paul R,Gosselin RA

    更新日期:2005-04-01 00:00:00

  • Magnetic Resonance Imaging of Trauma Patients Treated With Contemporary External Fixation Devices: A Multicenter Case Series.

    abstract:OBJECTIVES:To report the safety and clinical outcomes of placing current magnetic resonance imaging (MRI) components inside and outside the MRI bore during MRIs. DESIGN:Retrospective case series. SETTING:Four trauma centers (3 Level I and 1 Level II), from January 2005 to January 2015. PATIENTS:All patients who had ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,多中心研究

    doi:10.1097/BOT.0000000000000954

    authors: Hayden BL,Theriault R,Bramlett K,Lucas R,McTague M,Bedi HS,Flacke S,Weaver MJ,Marcantonio AJ,Ryan SP

    更新日期:2017-11-01 00:00:00

  • The Incidence and Risk Factors Associated With the Need for Fasciotomy in Tibia and Forearm Fractures: An Analysis of the National Trauma Data Bank.

    abstract:OBJECTIVE:The aims of this study were to analyze a large national trauma database to determine the incidence of, risk factors for, and outcomes after a fasciotomy of the lower leg or forearm after fracture. METHODS:Data from the National Trauma Data Bank for the years 2004-2016 were analyzed, and we identified 301,351...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001702

    authors: Saiz AM Jr,Wellman AC,Stwalley D,Wolinsky P,Miller AN

    更新日期:2020-05-01 00:00:00

  • False positive indium-111 white blood cell scan in a closed clavicle fracture.

    abstract::Aggressive treatment of the multiply injured patient often requires early fixation of many fractures, some of which may be open. Often, patients develop postoperative fevers requiring a thorough workup to rule out infection. Recently, indium-111 white blood cell (WBC) imaging has become a valuable adjunct in the diagn...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:

    authors: Friedman RJ,Gordon L

    更新日期:1988-01-01 00:00:00

  • Novel Treatment Options for the Surgical Management of Young Femoral Neck Fractures.

    abstract::In physiologically young patients with displaced femoral neck fractures, surgical treatment is aimed at achieving fracture union while preserving native hip anatomy and biomechanics. The intracapsular environment, tenuous vascular supply, and unfavorable hip biomechanics contribute to the high complication rates seen ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,评审

    doi:10.1097/BOT.0000000000001368

    authors: Levack AE,Gausden EB,Dvorzhinskiy A,Lorich DG,Helfet DL

    更新日期:2019-01-01 00:00:00

  • Inadvertent intraforaminal iliosacral screw placement despite apparent appropriate positioning on intraoperative fluoroscopy.

    abstract::We present the case of an intraforaminal iliosacral screw placed percutaneously with aid of C-arm using inlet, outlet, and lateral views of the pelvis. The iliosacral screw was placed above the S1 foramen on the outlet view, into the middle of S1 via the ala on the inlet view, and below the cortical shadow of the ala ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200502000-00010

    authors: Sagi HC,Lindvall EM

    更新日期:2005-02-01 00:00:00

  • Definitive Management of Distal Tibia and Simple Plafond Fractures With Circular External Fixation.

    abstract::Obtaining optimal results in the treatment of extraarticular distal tibia fractures can be challenging. Plate and screw and intramedullary fixation have proven to be effective treatments, but are associated with significant complication rates when used for open fractures and patient with severe medical comorbidities. ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000000694

    authors: Quinnan SM

    更新日期:2016-11-01 00:00:00

  • Multiplanar Fixation for Patella Fractures Using a Low-Profile Mesh Plate.

    abstract::Patella fractures are challenging orthopaedic injuries. Many commonly used fixation techniques can be ineffective and lead to poor clinical outcomes even with satisfactory reductions and fracture healing. In this investigation, we present the technique of cage plate fixation of patella fractures and the clinical outco...

    journal_title:Journal of orthopaedic trauma

    pub_type: 临床试验,杂志文章

    doi:10.1097/BOT.0000000000000415

    authors: Lorich DG,Warner SJ,Schottel PC,Shaffer AD,Lazaro LE,Helfet DL

    更新日期:2015-12-01 00:00:00

  • Is There an Impact of Concomitant Injuries and Timing of Fixation of Major Fractures on Fracture Healing? A Focused Review of Clinical and Experimental Evidence.

    abstract:OBJECTIVE:This review aims to summarize current knowledge regarding the underlying patho-mechanisms of delayed fracture healing in polytraumatized patients. DATA SOURCES AND STUDY SELECTION:The following search terms were used: "fracture", "hemorrhage," "chest trauma," "inflammation," "inflammatory response," "fractur...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,meta分析,评审

    doi:10.1097/BOT.0000000000000489

    authors: Hildebrand F,van Griensven M,Huber-Lang M,Flohe SB,Andruszkow H,Marzi I,Pape HC,Trauma Research Network of the German Society of Trauma, DGU.

    更新日期:2016-03-01 00:00:00

  • The accuracy of fine wire tensioners: a comparison of five tensioners used in hybrid and ring external fixation.

    abstract:OBJECTIVES:To compare the accuracy of 5 commonly available fine wire tensioners used in hybrid and ring external fixation. DESIGN:A laboratory investigation. SETTING:The testing of 5 commonly available tensioners was performed with a servohydraulic test frame (MTS Bionix 858, Minneapolis, MN). MAIN OUTCOME MEASUREME...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200403000-00006

    authors: Roberts CS,Antoci V,Antoci V Jr,Voor MJ

    更新日期:2004-03-01 00:00:00

  • Comparison of the 95-degree angled blade plate and the locking condylar plate for the treatment of distal femoral fractures.

    abstract:OBJECTIVES:In the distal femur, locked plating is efficacious when coronal fractures preclude the use of a conventional fixed-angle device. However, minimal comparative data exist for supracondylar fracture patterns, which could be treated with other devices. The purpose of this study was to compare the 95-degree angle...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e318234d460

    authors: Vallier HA,Immler W

    更新日期:2012-06-01 00:00:00

  • Harvesting of autogenous cancellous bone graft from the proximal tibial metaphysis. A review of 230 cases.

    abstract::A study was undertaken to review the results of donor site morbidity of cancellous bone grafts obtained from the proximal tibial metaphysis. Two hundred six patients who underwent 230 proximal tibial bone graft harvestings were reviewed. Patients with lower-extremity fractures or nonunions who required cancellous bone...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199112000-00014

    authors: O'Keeffe RM Jr,Riemer BL,Butterfield SL

    更新日期:1991-01-01 00:00:00

  • Intramedullary allograft fibula as a reduction and fixation tool for treatment of complex proximal humerus fractures with diaphyseal extension.

    abstract:SUMMARY:In this study, we present a novel technique for reduction and fixation of complex, unstable proximal humerus fractures with diaphyseal extension with the assistance of fibula allograft. We treated 14 patients using this technique since 2009 and found that it improves the reduction and enhances fixation while ma...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e31829a346d

    authors: Berkes MB,Little MT,Lazaro LE,Cymerman RM,Pardee NC,Helfet DL,Dines JS,Lorich DG

    更新日期:2014-03-01 00:00:00

  • A prospective, randomized study of intramedullary nails inserted with and without reaming for the treatment of open and closed fractures of the tibial shaft.

    abstract:OBJECTIVES:To determine if there are differences in healing, complications, or number of procedures required to obtain union among open and closed tibia fractures treated with intramedullary (IM) nails inserted with and without reaming. DESIGN:Prospective, surgeon-randomized comparative study. SETTING:Level One traum...

    journal_title:Journal of orthopaedic trauma

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00005131-200003000-00007

    authors: Finkemeier CG,Schmidt AH,Kyle RF,Templeman DC,Varecka TF

    更新日期:2000-03-01 00:00:00

  • A Novel Traction Frame for Femur Fracture Management in Developing Countries: Technique and Outcomes.

    abstract::Fractures of the femur have long been a major cause of morbidity and mortality in developing countries and are most frequently caused by road traffic accidents. Intramedullary nail fixation has become the gold standard of care for diaphyseal fractures of the femur. However, modern techniques require proper implants, a...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,多中心研究

    doi:10.1097/BOT.0000000000001407

    authors: Levy DM,Meadows MC,Gates DJ

    更新日期:2019-05-01 00:00:00

  • Subchondral screw fixation of cervical hip fractures: joint congruence studied with combined arthrography and tomography.

    abstract::This study was done to determine whether fixation with the Uppsala internal fixation technique into the subchondral bone of the femoral head in the treatment of cervical hip fractures could lead to elevation of the femoral head cartilage. Combined arthrography and frontal tomography of the hip joint in the plane of th...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-198909000-00004

    authors: Rehnberg L,Olerud C,Sahlstedt B

    更新日期:1989-01-01 00:00:00

  • Physical Performance Limitations After Severe Lower Extremity Trauma in Military Service Members.

    abstract:OBJECTIVES:To characterize the type and magnitude of lower extremity physical performance deficits in military service members who have undergone rehabilitation after limb salvage or transtibial amputation. DESIGN:Cross-sectional prospective. SETTING:Level I trauma military medical and rehabilitation center. PATIENT...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001103

    authors: Wilken JM,Roy CW,Shaffer SW,Patzkowski JC,Blanck RV,Owens JG,Hsu JR

    更新日期:2018-04-01 00:00:00

  • Distal locking screw insertion using a cannulated drill bit: technical note.

    abstract::A modified freehand method using a cannulated drill bit for the insertion of distal locking screws for interlocking intramedullary nails is described. It should be useful to introduce surgeons to interlocking and to aid those who are not comfortable with the freehand method. ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199306000-00009

    authors: Barrick EF

    更新日期:1993-01-01 00:00:00

  • Complex volar distal radioulnar joint dislocation occurring in a Galeazzi fracture.

    abstract::The Galeazzi fracture-dislocation of the forearm consists of a transverse or short oblique fracture of the radius at the junction of the middle and distal thirds with an associated subluxation or dislocation of the distal radioulnar joint. Anatomic reduction with rigid internal fixation of the radius typically produce...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-198903010-00015

    authors: Giangarra CE,Chandler RW

    更新日期:1989-01-01 00:00:00

  • Primary total hip arthroplasty with a Burch-Schneider antiprotrusion cage and autologous bone grafting for acetabular fractures in elderly patients.

    abstract:OBJECTIVES:To investigate the clinical and functional outcome in an elderly population with acetabular fractures after low-energy trauma treated acutely with a total hip arthroplasty supported by a reinforcement ring (Burch-Schneider antiprotrusion cage) and autologous bone grafting of the acetabulum. SETTING:Universi...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200303000-00007

    authors: Tidermark J,Blomfeldt R,Ponzer S,Söderqvist A,Törnkvist H

    更新日期:2003-03-01 00:00:00

  • The trochanteric C-clamp for provisional pelvic stability.

    abstract::The application of a pelvic clamp for provisional stability of unstable pelvic fractures has been advocated in the orthopaedic literature. Although the technique has gained some supporters, problems with placement and associated complications have prevented widespread acceptance. We have modified the pelvic clamp (ACE...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/01.bot.0000175156.92743.db

    authors: Archdeacon MT,Hiratzka J

    更新日期:2006-01-01 00:00:00

  • Treatment of displaced, proximal, humeral, epiphyseal fractures with a two-prong splint.

    abstract::To evaluate the use of a two-prong splint for displaced, proximal, humerus, epiphyseal fractures, seven children with Neer-Horwitz Classification Type 3-4 fractures of the proximal humerus were retrospectively investigated. After closed reduction, fracture stabilization was accomplished with the use of a two-prong spl...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200309000-00007

    authors: Karatosun V,Unver B,Alici E,Serin E

    更新日期:2003-09-01 00:00:00

  • Character, Incidence, and Predictors of Knee Pain and Activity After Infrapatellar Intramedullary Nailing of an Isolated Tibia Fracture.

    abstract:OBJECTIVE:To study the activity and incidence of knee pain after sustaining an isolated tibia fracture treated with an infrapatellar intramedullary nail at 1 year. DESIGN:Retrospective review of prospective cohort. SETTING:Multicenter Academic and Community hospitals. PATIENTS:Four hundred thirty-seven patients with...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,多中心研究

    doi:10.1097/BOT.0000000000000475

    authors: Obremskey W,Agel J,Archer K,To P,Tornetta P 3rd,SPRINT Investigators.

    更新日期:2016-03-01 00:00:00