The olecranon sled—a new device for fixation of fractures of the olecranon: A mechanical comparison of two fixation methods in cadaver elbows

Dieterich, Jan; Kummer, Frederick J.; Ceder, Leif

doi:10.1080/17453670610046370

Cited by 16 publications

(5 citation statements)

References 16 publications

(21 reference statements)

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“…The advantages of low prominence and secure fixation of the sled may play an important role in reducing the rate of symptomatic metalwork removal [ 15 ]. Moreover, it can provide good clinical outcomes for olecranon fractures [ Fig.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of olecranon sled fixation in patients with Mayo type II olecranon fractures

Chen,

Zhang,

Cao

et al. 2024

Heliyon

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Section: Discussionmentioning

confidence: 99%

Clinical outcomes of olecranon sled fixation in patients with Mayo type II olecranon fractures

Chen,

Zhang,

Cao

et al. 2024

Heliyon

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“…7 In this cadaveric study, simulated transverse olecranon fractures were fixed with either the olecranon sled or bicortical K-wires and tension band wiring. After application of cyclic loading of the biceps and triceps to the construct, there was no statistically significant difference in fracture displacement between the 2 fixation methods.…”

Section: Discussionmentioning

confidence: 99%

“…Biomechanical testing has shown that the olecranon sled performs similarly to a tension band construct in cadaveric models of olecranon fracture. 7 The purpose of this study is to evaluate our technique in using the olecranon sled in patients to repair olecranon osteotomies for exposure of intra-articular distal humerus fractures and to evaluate early outcomes and complications.…”

Section: Historical Perspectivementioning

confidence: 99%

Olecranon Osteotomy Fixation Using a Novel Device

Iorio

Wong

Patterson

et al. 2013

Techniques in Hand &Amp; Upper Extremity Surgery

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A posterior approach to the elbow utilizing an olecranon osteotomy has been shown to provide excellent visualization of the distal humerus articular surface. However, many bony stabilization and fixation methods for the olecranon osteotomy are usually prominent, frequently symptomatic, and often require a second operation for removal. This paper evaluates the use of an innovative device, the olecranon sled, in fixation of olecranon osteotomies for exposure of intra-articular distal humerus fractures and provides follow-up results. A retrospective review of all patients with intra-articular distal humerus fracture treated through an olecranon osteotomy approach and fixed with an olecranon sled, between September 2008 and December 2011 was conducted. Charts and radiographs were reviewed to determine olecranon union or nonunion, presence of symptomatic hardware, and need for secondary surgery to remove symptomatic olecranon fixation. Fourteen patients were included in the study. Average clinical follow-up was 33.5 weeks (range, 6 to 118 wk). There were no olecranon nonunions. One patient underwent additional surgery for symptomatic hardware removal (7.1%). Two additional procedures were performed; 1 for revision open reduction and internal fixation of distal humerus fracture nonunion (7.1%) and 1 for release of elbow contracture (7.1%). Although follow-up is limited, the use of this device has been associated with excellent rates of olecranon union with a low rate of symptomatic hardware requiring removal.

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“…To our knowledge, only 1 previous biomechanical study has compared the continuous loop construct with the traditional K-wire and tension band technique, finding no difference in osteotomy displacement. 5 However, the study did not compare intramedullary screw with tension band fixation or comment on hardware prominence. 5 Limited clinical data are available on the use of the Olecranon Sled.…”

mentioning

confidence: 99%

“…5 However, the study did not compare intramedullary screw with tension band fixation or comment on hardware prominence. 5 Limited clinical data are available on the use of the Olecranon Sled. 9,13 Iorio et al 9 reported on 14 patients, with 1 requiring hardware removal.…”

mentioning

confidence: 99%

Biomechanical Comparison of Olecranon Sled Versus Intramedullary Screw Tension Banding for Olecranon Osteotomies

Kia

Dukas

Marshall

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background:Olecranon osteotomies are frequently performed to gain access to the distal humeral articular surface. Repair of the osteotomy or fixation of a simple 2-part olecranon fracture with traditional tension band construct is often plagued by complication. Proximal migration and irritation attributed to hardware are common complications of the standard construct of an intramedullary screw with tension band and are causes for reoperation.Purpose:To compare the biomechanical performance, time of implant, and prominence of an intramedullary screw and tension band construct with that of a newer low-profile continuous loop tension band (Olecranon Sled) construct in an olecranon osteotomy model.Study Design:Controlled laboratory study.Methods:Chevron osteotomies were created in 6 matched pairs of fresh-frozen human elbows (mean age, 66 ± 16 years). Each matched pair was then randomly divided into 1 of 2 groups: fixation with a screw and tension band construct or the Olecranon Sled. Bone mineral density, implant prominence, and time for implantation were recorded. Following olecranon fixation, each specimen underwent cyclic loading of 0 to 10 N for 100 cycles (to simulate unresisted active range of motion) and then 0 to 500 N for 500 cycles (to simulate pushing up from a chair) to measure for any displacement at the osteotomy site. The constructs were then loaded to failure and compared.Results:No differences were found in bone mineral density between the 2 groups (P = .290). When measured from the tip of the olecranon, the continuous loop tension band had a medial prominence of only 3.57 ± 0.4 mm, as opposed to the intramedullary screw fixation of 7.288 ± 0.762 mm (P = .027). Total time of implantation, including osteotomy preparation, was a mean 155 seconds shorter with the Olecranon Sled versus the traditional tension band (P < .05). Because of the fracture of 1 specimen during cyclic loading, it and its matched counterpart were excluded, and only 5 matched pairs were analyzed for displacement and load to failure. There were no significant differences between groups in load to failure or displacement during cyclic loading (P > .05).Conclusion:The Olecranon Sled device was found to have no difference in biomechanical strength from that of the standard intramedullary screw with tension band construct. The Olecranon Sled was also found to be significantly less prominent while being faster to implant than the intramedullary screw.Clinical Relevance:Evaluating an alternative option to the standard tension band construct is important for patients with olecranon fractures or osteotomies, as standard techniques have been fraught with hardware issues and need for revision surgery.

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The olecranon sled—a new device for fixation of fractures of the olecranon: A mechanical comparison of two fixation methods in cadaver elbows

Cited by 16 publications

References 16 publications

Clinical outcomes of olecranon sled fixation in patients with Mayo type II olecranon fractures

Clinical outcomes of olecranon sled fixation in patients with Mayo type II olecranon fractures

Olecranon Osteotomy Fixation Using a Novel Device

Biomechanical Comparison of Olecranon Sled Versus Intramedullary Screw Tension Banding for Olecranon Osteotomies

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