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Xia D, Zhou P, Li L, Xia Y, Hao Z, Zhang Y, Xu S. Application of a novel shape-memory alloy concentrator in displaced olecranon fractures: a report of the technique and mid-term clinical results. J Orthop Surg Res 2020; 15:453. [PMID: 33008473 PMCID: PMC7531136 DOI: 10.1186/s13018-020-01982-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 09/23/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose Olecranon fracture is a common upper limb fracture, and several surgical approaches have been advocated for its fixation. To overcome the complications associated with common techniques, we present a novel shape-memory alloy concentrator, an alternative for tension band compression, to fix olecranon fracture. Methods Fifty-seven patients (26 men and 31 women) with olecranon fracture, with a mean age of 45 years, were included in this study. Each patient had undergone open reduction and internal fixation using the Nitinol (Ni-Ti) arched shape-memory connector (ASC). The clinical assessments were performed using the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire and the Mayo Elbow Performance (MEP) score, which were both recorded at the final follow-up visit. Results The patients were followed up for 44 months on average (range, 31 to 56 months). No patients were lost to follow-up, and all of the olecranon fractures healed in an average of 15 weeks (range, 10 to 34 weeks). The mean DASH score was 8.6 (range, 0 to 32.4), and the mean MEP score was 92.5 (range, 74 to 100). Nine patients showed postoperative complications: prominent hardware (2), infection (1), loss of the range of functional motion (5), and heterotopic ossification (1). Conclusion The ASC may serve as a favorable device for multi-fragmented and comminuted fractures with rare hardware irritation and may also provide continuous concentrative compression to accelerate osseous healing, thereby aiding the restoration and permitting an early rehabilitation with a low incidence of postoperative complications.
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Affiliation(s)
- Demeng Xia
- Department of Emergency, Changhai Hospital, the Naval Medical University, No.168, Changhai St, Shanghai, 200433, People's Republic of China.,Department of Orthopaedics, Eastern Theater Naval Hospital, No. 98, Wenhua St, Zhoushan, Zhejiang, 316000, People's Republic of China
| | - Panyu Zhou
- Department of Emergency, Changhai Hospital, the Naval Medical University, No.168, Changhai St, Shanghai, 200433, People's Republic of China
| | - Lei Li
- Department of Emergency, Changhai Hospital, the Naval Medical University, No.168, Changhai St, Shanghai, 200433, People's Republic of China
| | - Yan Xia
- Department of Emergency, Changhai Hospital, the Naval Medical University, No.168, Changhai St, Shanghai, 200433, People's Republic of China
| | - Zichen Hao
- Department of Emergency, Changhai Hospital, the Naval Medical University, No.168, Changhai St, Shanghai, 200433, People's Republic of China
| | - Yuntong Zhang
- Department of Emergency, Changhai Hospital, the Naval Medical University, No.168, Changhai St, Shanghai, 200433, People's Republic of China.
| | - Shuogui Xu
- Department of Emergency, Changhai Hospital, the Naval Medical University, No.168, Changhai St, Shanghai, 200433, People's Republic of China.
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Effect of Elbow Position on Load to Failure in Olecranon Fracture Fixation: A Biomechanical Cadaveric Study. J Orthop Trauma 2019; 33:256-260. [PMID: 30633081 DOI: 10.1097/bot.0000000000001423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES This study evaluates if relative flexion or extension of the ulnohumeral joint affects the strength of repair in olecranon fractures treated with a precontoured locking plate. METHODS A cadaveric study was performed in matched pair cadaveric elbows. All soft tissue was dissected from the radius, ulna, and elbow of each specimen, leaving interosseous ligaments and joint capsules intact. Soft tissue from the humerus was dissected away, leaving only the triceps tendon and ulnar insertions intact. An oblique proximal to distal olecranon osteotomy was created in each specimen 1 cm from the tip of the olecranon. Internal fixation with standard precontoured locking plates and a Krackow augmentation suture with #2 FiberWire followed. Specimens were randomized to elbow position of 90 or 20 degrees° and loaded to failure via axial pull through the triceps. Load at failure, displacement at the time of failure, peak load, stiffness, and mechanism of failure was recorded and compared. The study was repeated a second time with the osteotomy more proximal, 0.6 cm creating a smaller fragment with less opportunities for locking screw fixation. This small fragment group was then tested as the large fragment group had. RESULTS There were no significant differences in load at failure, peak load, or stiffness between the elbow position in the large fragment group. Displacement at time of failure was significantly different, although not clinically relevant. Failure of fixation in this group was a mix of triceps avulsion and failure through fracture site. The smaller fragment group with less points of fixation demonstrated no statistically significant differences in any parameters. A majority of the failures were at the fracture site. CONCLUSIONS Ulnohumeral position does not significantly affect overall construct strength even in olecranon fractures with small proximal fragments with limited points of fixation.
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