Zumstein, Matthias A; Bürki, Alexander; Massy, Anne-Sophie; Zysset, Philippe; Moor, Beat K (2015). Extra-articular step osteotomy of the olecranon: A biomechanical assessment. Clinical biomechanics, 30(10), pp. 1043-1048. Elsevier 10.1016/j.clinbiomech.2015.09.009
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BACKGROUND
Trans-olecranon chevron osteotomies (COs) remain the gold standard surgical approach to type C fractures of the distal humerus. This technique is associated with a high complication rate and development of an extra-articular olecranon osteotomy may be advantageous. The aim of this study was to compare the load to failure of COs with extra-articular oblique osteotomies (OOs) as well as modified, extra-articular step osteotomies (SOs).
METHODS
These three osteotomies and their subsequent fixation utilizing a standardized tension band wiring technique were tested in 42 composite analog ulnae models at 20° and 70° of flexion. Triceps loading was simulated with a servo hydraulic testing machine. All specimens were isometrically loaded until failure. Kinematic and force data, as well as interfragmentary motion were recorded.
RESULTS
At 70°, CO failed at a mean load of 963N (SD 104N), the OO at 1512N (SD 208N) and the SO at 1484N (SD 153N), (P<0.001). At 20°, CO failed at a mean load of 707N (SD 104N) and OO at 1009N (SD 85N) (P=0.006). The highest load to failure was observed for the SO, which was 1277N (SD 172N). The load to failure of the SO was significantly higher than the CO as well as the OO.
CONCLUSION
Extra-articular osteotomies showed a significantly higher load to failure in comparison to traditional CO. At near full extension (20° of flexion), this biomechanical advantage was further enhanced by a step-cut modification of the extra-articular oblique osteotomy.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery |
UniBE Contributor: |
Zumstein, Matthias, Moor, Beat Kaspar |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0268-0033 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Fabian Röthlisberger |
Date Deposited: |
22 Mar 2016 08:22 |
Last Modified: |
05 Dec 2022 14:52 |
Publisher DOI: |
10.1016/j.clinbiomech.2015.09.009 |
PubMed ID: |
26443882 |
Uncontrolled Keywords: |
Elbow; Extensor mechanism; Olecranon osteotomy; Posterior approach; Triceps insertion |
BORIS DOI: |
10.7892/boris.77114 |
URI: |
https://boris.unibe.ch/id/eprint/77114 |
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