Distal Ulna Fractures

Collins, Melissa; Hart, Adam; Hines, Jerod; Steffen, Thomas; Harvey, Edward J.; Martineau, Paul A.

doi:10.1097/bot.0000000000000021

Cited by 6 publications

(9 citation statements)

References 15 publications

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“…The loads in this study were selected to simulate extreme physiological loading such as lifting a heavy grocery bag with the forearm in a horizontal position. 18,20,21 Furthermore, these loads did not cause plastic deformation, as indicated by the complete recovery of motion after each iteration. Clearly, these loading conditions are beyond those experienced during healing of an ulna with rigid fixation; however, they were still valid for nondestructive cyclic loading.…”

Section: Discussionmentioning

confidence: 94%

“…These observations suggested that a considerable stress concentration was applied at the distal-most screw following sagittal plane bending loads for 3.5-mm constructs. 18,44 In addition, none of the 2.7-mm constructs with a transverse fracture completely detached. Instead, the plate bent considerably, plastically deforming, and displaced the fracture.…”

Section: Discussionmentioning

confidence: 99%

“…10,18,19 Previous biomechanical studies have assessed the structural stability of ulnar fractures for various conditions affecting mechanical strength of the fracture fixation construct, such as gap size, number and positon of screws, and distance between plate and bone. 18,20,21 As many factors influence fracture stability, conflicting data exists. [22][23][24][25] Regardless, plate length and size are recognized as important factors in determining fracture stability and the outcome of bone healing; however, few studies have assessed structural stability as a function of plate size in ulnar fractures.…”

Section: Introductionmentioning

confidence: 99%

“…14,16,17 Accordingly, there has been interest in the use of lower profile plates to decrease implant prominence. 10,18,19 Previous biomechanical studies have assessed the structural stability of ulnar fractures for various conditions affecting mechanical strength of the fracture fixation construct, such as gap size, number and positon of screws, and distance between plate and bone. 18,20,21 As many factors influence fracture stability, conflicting data exists.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of a 2.7-mm and 3.5-mm locking compression plate for ulnar fractures: a biomechanical evaluation

Wahbeh,

Kelley,

Shokoohi

et al. 2023

OTA International: The Open Access Journal of Orthopaedic Trauma

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Objectives: Implant prominence after ulnar fracture fixation may be mitigated by the use of lower profile plates. The biomechanical strength and stability of 2.7-mm and 3.5-mm locking compression plates for fixation were compared. Methods: Two fracture conditions, transverse (N = 10) and oblique (N = 10), were evaluated in an in vitro study. Half of the specimens for each condition were fixed with 2.7-mm plates and the other half with 3.5-mm plates, all fixed with conventional dynamic compression mechanisms. Specimens were loaded under ±2 Nm of cyclic axial torsion, then under 10 Nm of cyclic cantilever bending, and bending to failure. Interfragmentary motion and strain were analyzed to determine construct stability as a function of fracture pattern and plate size. Results: Interfragmentary motion was significantly larger in all constructs fixed with 2.7-mm plates, compared with 3.5-mm plates (P < 0.01). The 2.7-mm constructs with transverse fractures had the greatest motion, ranging between 5° and 10° under axial rotation and 5.0–6.0 mm under bending. Motions were the lowest for 3.5-mm constructs with oblique fractures, ranging between 3.2 and 4.2 mm under bending and 2°–3.5° for axial rotation. For oblique fractures, the bending moment at ultimate failure was 31.4 ± 3.6 Nm for the 2.7-mm constructs and 10.0 ± 1.9 Nm for 3.5-mm constructs (P < 0.01). Similarly, for transverse fractures, the bending moment was 17.9 ± 4.0 Nm for the 2.7-mm constructs and 9.7 ± 1.3 Nm for the 3.5-mm constructs (P < 0.01). Conclusions: Although 3.5-mm plates were more effective at reducing fracture motion, they were consistently associated with refracture at the distal-most screw hole under load to failure. By contrast, 2.7-mm plates plastically deformed despite excessive loads, potentially avoiding a subsequent fracture. Level of Evidence: Level V.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of a 2.7-mm and 3.5-mm locking compression plate for ulnar fractures: a biomechanical evaluation

Wahbeh,

Kelley,

Shokoohi

et al. 2023

OTA International: The Open Access Journal of Orthopaedic Trauma

View full text Add to dashboard Cite

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“…The final destructive tests revealed that axial rotational loading in which the locked plate is constructed failed earlier than the nonlocked plates. 50 Therefore, based on the current evidence, both types of plates can be used in USO surgery without a preference for one over the other.…”

Section: Introductionmentioning

confidence: 99%

Guidelines for the Diagnosis and Treatment of Ulnar Impaction Syndrome (2024)

Xu,

Ho,

Nakamura

et al. 2024

J Wrist Surg

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Background: Ulnar impaction syndrome (UIS), also known as ulnar impaction or ulnar abutment, is a degenerative condition causing pain on the ulnar side of the wrist. It can lead to wrist bone necrosis, resulting in wrist joint stability disruption and a significant wrist function impairment. The global understanding of this condition varies, contributing to substantial differences in clinical outcomes. Purposes: This paper underscores the necessity of developing evidence-based clinical guidelines for UIS to guide clinicians in their diagnostic and therapeutic approaches. Methods: In collaboration with the Asian Pacific Wrist Association, a team of experts from various fields within the Hand Surgery Department at Huashan Hospital has collectively formulated the “Clinical Practice Guidelines for Ulnar Impaction Syndrome (2024)” (hereinafter referred to as the “Guidelines”). The development process adhered to the guidelines outlined in the World Health Organization's handbook for guideline development. Results: Ten key questions and 21 recommendations are formed. The Guidelines provide recommendations for UIS diagnosis, criteria for selecting conservative or surgical interventions, options for surgical procedures, and address various related issues. Conclusions: The collaborative effort aims to standardize clinical practices, enhance diagnostic accuracy, and improve treatment outcomes for individuals affected by UIS, with these recommendations intended to serve as a valuable reference for healthcare professionals.

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