Sequence of the Essex-Lopresti lesion—a high-speed video documentation and kinematic analysis

Wegmann, Kilian; Engel, Karsten; Burkhart, Klaus J.; Ebinger, Marc; Holz, Robert K.; Brüggemann, Gert–Peter; Müller, Lars Peter

doi:10.3109/17453674.2014.887952

Cited by 22 publications

(13 citation statements)

References 20 publications

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“…Then, in relation to the forearm, the wrist was slightly supinated and the specimen was put under axial preload of 3 kg. After that, axial impaction (energy of about 130 J) was applied to the specimens, using the impact-mechanism of the fracture simulator [8,9].…”

Section: Specimen Preparationmentioning

confidence: 99%

Advanced Surgical Trauma Care Course – Evaluation of a Fracture Simulation Course Concept with Intact Soft Tissue

et al. 2019

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Purpose Currently, surgical training in the clinical scenario is limited by duty-hour restrictions as well as an increasing specialization within the numerous surgical fields. In such an environment, surgical training in subspecialties becomes both, more important and challenging. Against this background, purpose of the present study was to evaluate a new course format for advanced training in fracture treatment. In the studied course format, cadaveric wrist or elbow specimens with prefabricated fractures were used with the aim of improving the learning effect for the attendees. On these specimens, operative treatment with specific osteosynthetic implants was performed under radiographic control. We hypothesized that simulation in a complex scenario such as the one used in the studied course format leads to a subjectively better learning effect regardless of prior surgical experience. Methods 205 participants in 16 courses between 2016 and 2018 were surveyed regarding their operative experience, previously attendances of trauma care trainings and subjective learning effect in the surveyed course and the trainings attended previously. Based on a ten-step scale, results in the subjective learning effect were compared between the investigated course and other trainings and to the individual operative experience. Results The learning effect of the surveyed fracture courses was assessed with a median of 9/10 for the theoretical part and 10/10 for the practical part, significantly better than in trainings attended previously. The surveyed participants reported that they each performed 308 operations per year on average. Other course formats were attended significantly more frequent than courses on prefractured human specimens. The respondents reported a subjectively higher learning effect of the evaluated course concept in comparison to previously attended courses in practical and theoretical aspects. Conclusions The reported innovative course format is an efficient concept for education in surgical trauma care, suited for more novice and advanced surgeons.

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Section: Specimen Preparationmentioning

confidence: 99%

Advanced Surgical Trauma Care Course – Evaluation of a Fracture Simulation Course Concept with Intact Soft Tissue

et al. 2019

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“…14,25 Though radial head fracture has been thought to be the primary event of the ELI, high-speed video data from simulated axial load injuries in cadavers indicate that the injury may be initiated by transverse radioulnar displacement with IOM disruption, followed by fracture of the radial head. 26 When the IOM is disrupted, it is no longer able to transmit force from the radius to the ulna. 27 If longitudinal instability exists, excision of the radial head can result in proximal migration of the radius.…”

Section: Interosseous Membranementioning

confidence: 99%

Management of the Essex-Lopresti Injury

Matson

Ruch

2016

Jnl Wrist Surg

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Essex-Lopresti injuries (ELIs) are characterized by fracture of the radial head, disruption of the forearm interosseous membrane, and dislocation of the distal radioulnar joint. This injury pattern results in axial and longitudinal instability of the forearm. Initial radiographs may fail to reveal the full extent of the injury, and therefore diagnosis in the acute setting requires a high index of suspicion. Early recognition and treatment are preferred as failure to fully treat the problem may result in chronic wrist pain from ulnar abutment or chronic elbow pain from radiocapitellar arthrosis. In this article the presentation, relevant anatomy, and management options for ELIs are overviewed, and a summary of outcomes reported in the literature is provided. Additionally, the preferred surgical technique of the senior author is presented, which involves reconstruction of the interosseous membrane with a local pronator rerouting autograft.

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“…However, the biomechanical properties of fractured bones might not only play a crucial role in vivo, but also when testing fresh-frozen human cadaveric specimens. Fracture creation using a drop tower is often applied to understand the pathomechanics of specific fracture patterns [ 6 ]. However, it often results in complex multi-fragmentary patterns that cannot be reproducibly standardized.…”

Section: Introductionmentioning

confidence: 99%

Standardized artificially created stable pertrochanteric femur fractures present more homogenous results compared to osteotomies for orthopaedic implant testing

Schader

Gehweiler

Dauwe

et al. 2021

BMC Musculoskelet Disord

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Background With regard to biomechanical testing of orthopaedic implants, there is no consensus on whether artificial creation of standardized bone fractures or their simulation by means of osteotomies result in more realistic outcomes. Therefore, the aim of this study was to artificially create and analyze in an appropriate setting the biomechanical behavior of standardized stable pertrochanteric fractures versus their simulation via osteotomizing. Methods Eight pairs of fresh-frozen human cadaveric femora aged 72.7 ± 14.9 years (range 48–89 years) were assigned in paired fashion to two study groups. In Group 1, stable pertrochanteric fractures AO/OTA 31-A1 were artificially created via constant force application on the anterior cortex of the femur through a blunt guillotine blade. The same fracture type was simulated in Group 2 by means of osteotomies. All femora were implanted with a dynamic hip screw and biomechanically tested in 20° adduction under progressively increasing physiologic cyclic axial loading at 2 Hz, starting at 500 N and increasing at a rate of 0.1 N/cycle. Femoral head fragment movements with respect to the shaft were monitored by means of optical motion tracking. Results Cycles/failure load at 15° varus deformation, 10 mm leg shortening and 15° femoral head rotation around neck axis were 11324 ± 848/1632.4 ± 584.8 N, 11052 ± 1573/1605.2 ± 657.3 N and 11849 ± 1120/1684.9 ± 612.0 N in Group 1, and 10971 ± 2019/1597.1 ± 701.9 N, 10681 ± 1868/1568.1 ± 686.8 N and 10017 ± 4081/1501.7 ± 908.1 N in Group 2, respectively, with no significant differences between the two groups, p ≥ 0.233. Conclusion From a biomechanical perspective, by resulting in more consistent outcomes under dynamic loading, standardized artificial stable pertrochanteric femur fracture creation may be more suitable for orthopaedic implant testing compared to osteotomizing the bone.

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Sequence of the Essex-Lopresti lesion—a high-speed video documentation and kinematic analysis

Cited by 22 publications

References 20 publications

Advanced Surgical Trauma Care Course – Evaluation of a Fracture Simulation Course Concept with Intact Soft Tissue

Advanced Surgical Trauma Care Course – Evaluation of a Fracture Simulation Course Concept with Intact Soft Tissue

Management of the Essex-Lopresti Injury

Standardized artificially created stable pertrochanteric femur fractures present more homogenous results compared to osteotomies for orthopaedic implant testing

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