Nailing of proximal ulna fractures: biomechanical comparison of a new locked nail with angular stable plating

Hopf, Johannes Christof; Nowak, T.; Mehler, Dorothea; Arand, Charlotte; Gruszka, Dominik; Rommens, Pol Maria

doi:10.1007/s00068-019-01254-7

Cited by 7 publications

(8 citation statements)

References 36 publications

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“…A study comparing rotation and axial force should also be conducted later. The cyclic load of proximal ulna identified in the reference was 30-300 N [28], which was much lower than the force performed in this study, so no studies on repetitive and cyclic loading were conducted. Moreover, it was not possible to compare the union rate later.…”

Section: Discussionmentioning

confidence: 70%

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Comparison of Bending Strength among Plate, Steinmann Pin, and Headless Compression Screw Fixations for Proximal Ulnar Shaft Fracture in Sawbones

Han¹,

Oh²,

Um³

2020

Arch Hand Microsurg

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Purpose: Although plate osteosynthesis is commonly used to treat proximal ulna fracture, its treatment method is controversial because of complications such as large incision, long operation time, and soft tissue injury. Therefore, intramedullary headless compression screw (HCS) and Steinmann pin are considered as alternative treatment options. In this study, we aim to compare bending strength of plate and cortical screws, HCS, and Steinmann pin for proximal ulnar shaft fracture with sawbone. Methods: Transverse type fractures were made intentionally at the distal 7 cm from the proximal end of ulna sawbones and fixated with plate, HCS, and Steinmann pin after reduction. Three-point bending tests were performed with total of 21 sawbones, seven pieces for each group. Results: Average ultimate bending strength for each group was as follows; 521.7N for plate fixation group, 706.4N for HCS fixation group, and 812.6N for Steinmann pin fixation group. Statistically significant results were observed among the three groups (p<0.01). When two groups were compared separately, Steinmann pin fixation and plate fixation (p<0.01), Steinmann pin and HCS fixation (p=0.047) showed statistical significance. There was a significant trend between HCS and plate fixation group (p=0.064).Conclusion: HCS and Steinmann pin fixation showed higher bending strength when compared to plate fixation for proximal ulnar shaft fracture in sawbone. Although further studies are needed, HCS and Steinmann pin fixation are promising fixation methods that may be used as an alternative to plate fixation.

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Section: Discussionmentioning

confidence: 70%

“…Also, the number of experimental groups was small. As in the reference thesis using sawbone, 10 attempts were made [28], but due to the problem of research expenses, only seven groups were available. However, we tried to secure statistical significance with more numbers than six groups of reference papers using cadaver [29].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Bending Strength among Plate, Steinmann Pin, and Headless Compression Screw Fixations for Proximal Ulnar Shaft Fracture in Sawbones

Han¹,

Oh²,

Um³

2020

Arch Hand Microsurg

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“…Morphological properties of the proximal ulna and the entry point chosen at the olecranon have a high impact on the fit of the nail in the ulna bone, especially for non-anatomic shaped nails [25]. Geometrical characteristics of a newly designed short ulna nail for the treatment of proximal ulna fractures were described in detail in a recent biomechanical study [20].…”

Section: Plos Onementioning

confidence: 99%

“…As the inner cortical diameter can be as small as 2mm, reaming would be necessary prior to nail insertion. Biomechanically, the developed nail can be regarded as an alternative implant to plate fixation especially for the stabilisation of comminuted fractures [20].…”

Section: Plos Onementioning

confidence: 99%

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Computer tomographic analysis of anatomic characteristics of the ulna – essential parameters for preshaped implants

et al. 2020

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Anatomically preshaped implants are needed for exact restoration of the anatomy after fractures of the proximal ulna and ulnar shaft, which enables a good functional outcome. Aim of this computed tomographic analysis was to identify specific characteristics of the ulna. The data serve for the development of a new intramedullary implant for stabilisation of proximal and diaphyseal ulna fractures. Methods With a standardized research method 100 CT scans of the ulna were evaluated regarding anatomic parameters like width of the medullary canal, proximal ulna dorsal angulation and varus angulation. Also, correlations of these parameters were analyzed statistically. Results The mean proximal ulna dorsal angulation (PUDA) was 6.4˚(SD 2.8˚), while the mean varus angulation of the proximal ulna was 12.4˚(SD 3.3˚). The length of the ulna bone was 253.6 mm (SD 19.9 mm) on average. The average minimum diameter of the medullary canal was 4.2 mm (SD 1.1 mm) located at 141.3 mm (SD 19.7 mm) from the olecranon tip. There is a positive correlation between age and minimum diameter in our patient cohort (p< 0.001). Conclusion Our study described the anatomy of the proximal ulna and the ulna shaft with a reproducible research method in a representative patient cohort. The knowledge of the evaluated anatomic parameters can lead to an improvement of any implant design for the fixation of proximal and diaphyseal ulna fractures.

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Implants for Olecranon and Coronoid Fractures

Dirckx,

Jukes,

Phadnis

2022

Handbook of Orthopaedic Trauma Implantology

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Nailing of proximal ulna fractures: biomechanical comparison of a new locked nail with angular stable plating

Cited by 7 publications

References 36 publications

Comparison of Bending Strength among Plate, Steinmann Pin, and Headless Compression Screw Fixations for Proximal Ulnar Shaft Fracture in Sawbones

Comparison of Bending Strength among Plate, Steinmann Pin, and Headless Compression Screw Fixations for Proximal Ulnar Shaft Fracture in Sawbones

Computer tomographic analysis of anatomic characteristics of the ulna – essential parameters for preshaped implants

Implants for Olecranon and Coronoid Fractures

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