A biomechanical study comparing the mean load to failure of two different osteosynthesis techniques for step-cut olecranon osteotomy

Background: Olecranon osteotomies are frequently used to expose distal humeral intraarticular fractures. The step-cut olecranon osteotomy (SCOOT) is an augmented version of the oblique olecranon osteotomy, which has recently been evaluated biomechanically with tension band wiring (TBW) fixation. How...

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Autores principales:	Silvan Hess, MD, Alexander Bürki, MSc, Beat K. Moor, MD, Lilianna Bolliger, MSc, Philippe Zysset, PhD, Matthias A. Zumstein, MD
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Elbow Trauma Distal humeral fracture Olecranon osteotomy Surgical approach Biomechanics Surgery RD1-811
Acceso en línea:	https://doaj.org/article/09c17134782345ee9c6a8e71c846fa7f
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spelling	oai:doaj.org-article:09c17134782345ee9c6a8e71c846fa7f2021-11-22T04:32:11ZA biomechanical study comparing the mean load to failure of two different osteosynthesis techniques for step-cut olecranon osteotomy2666-639110.1016/j.xrrt.2021.07.004https://doaj.org/article/09c17134782345ee9c6a8e71c846fa7f2021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2666639121000705https://doaj.org/toc/2666-6391Background: Olecranon osteotomies are frequently used to expose distal humeral intraarticular fractures. The step-cut olecranon osteotomy (SCOOT) is an augmented version of the oblique olecranon osteotomy, which has recently been evaluated biomechanically with tension band wiring (TBW) fixation. However, complications with TBW are common. In this study, we, therefore, compared the mean load to failure of TBW with compression screws for SCOOT fixation. We hypothesized a higher load to failure for the compression screw group. Methods: We performed a SCOOT on 36 Sawbones. Eighteen were fixed with TBW, and another 18 with two compression screws. The humeroulnar joint was simulated using an established test setup, which allows the application of triceps traction force through a tendon model to the ulna, while the humeroulnar joint is in a fixed position. Eight models of each fixation group were tested at 20°, and eight at 70° of flexion by isometrical loading until failure, which was defined as either a complete fracture or gap formation of more than 2 mm at the osteotomy site. Results: At 20° of flexion, mean load to failure was similar between the TBW group (1360 ± 238 N) and the compression screw group (1401 ± 261 N) (P = .88). Also, at 70° of flexion, the mean load to failure was similar between the TBW group (1398 ± 215 N) and the compression screw group (1614 ± 427 N) (P = .28). Conclusions: SCOOTs fixed with TBW and compression screws showed similar loads to failure. A SCOOT fixed with compression screws might be a valuable alternative for surgeons when treating intraarticular distal humeral fractures. However, future in vivo studies are necessary to confirm our results in a clinical setting.Silvan Hess, MDAlexander Bürki, MScBeat K. Moor, MDLilianna Bolliger, MScPhilippe Zysset, PhDMatthias A. Zumstein, MDElsevierarticleElbowTraumaDistal humeral fractureOlecranon osteotomySurgical approachBiomechanicsSurgeryRD1-811ENJSES Reviews, Reports, and Techniques, Vol 1, Iss 4, Pp 414-420 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Elbow Trauma Distal humeral fracture Olecranon osteotomy Surgical approach Biomechanics Surgery RD1-811
spellingShingle	Elbow Trauma Distal humeral fracture Olecranon osteotomy Surgical approach Biomechanics Surgery RD1-811 Silvan Hess, MD Alexander Bürki, MSc Beat K. Moor, MD Lilianna Bolliger, MSc Philippe Zysset, PhD Matthias A. Zumstein, MD A biomechanical study comparing the mean load to failure of two different osteosynthesis techniques for step-cut olecranon osteotomy
description	Background: Olecranon osteotomies are frequently used to expose distal humeral intraarticular fractures. The step-cut olecranon osteotomy (SCOOT) is an augmented version of the oblique olecranon osteotomy, which has recently been evaluated biomechanically with tension band wiring (TBW) fixation. However, complications with TBW are common. In this study, we, therefore, compared the mean load to failure of TBW with compression screws for SCOOT fixation. We hypothesized a higher load to failure for the compression screw group. Methods: We performed a SCOOT on 36 Sawbones. Eighteen were fixed with TBW, and another 18 with two compression screws. The humeroulnar joint was simulated using an established test setup, which allows the application of triceps traction force through a tendon model to the ulna, while the humeroulnar joint is in a fixed position. Eight models of each fixation group were tested at 20°, and eight at 70° of flexion by isometrical loading until failure, which was defined as either a complete fracture or gap formation of more than 2 mm at the osteotomy site. Results: At 20° of flexion, mean load to failure was similar between the TBW group (1360 ± 238 N) and the compression screw group (1401 ± 261 N) (P = .88). Also, at 70° of flexion, the mean load to failure was similar between the TBW group (1398 ± 215 N) and the compression screw group (1614 ± 427 N) (P = .28). Conclusions: SCOOTs fixed with TBW and compression screws showed similar loads to failure. A SCOOT fixed with compression screws might be a valuable alternative for surgeons when treating intraarticular distal humeral fractures. However, future in vivo studies are necessary to confirm our results in a clinical setting.
format	article
author	Silvan Hess, MD Alexander Bürki, MSc Beat K. Moor, MD Lilianna Bolliger, MSc Philippe Zysset, PhD Matthias A. Zumstein, MD
author_facet	Silvan Hess, MD Alexander Bürki, MSc Beat K. Moor, MD Lilianna Bolliger, MSc Philippe Zysset, PhD Matthias A. Zumstein, MD
author_sort	Silvan Hess, MD
title	A biomechanical study comparing the mean load to failure of two different osteosynthesis techniques for step-cut olecranon osteotomy
title_short	A biomechanical study comparing the mean load to failure of two different osteosynthesis techniques for step-cut olecranon osteotomy
title_full	A biomechanical study comparing the mean load to failure of two different osteosynthesis techniques for step-cut olecranon osteotomy
title_fullStr	A biomechanical study comparing the mean load to failure of two different osteosynthesis techniques for step-cut olecranon osteotomy
title_full_unstemmed	A biomechanical study comparing the mean load to failure of two different osteosynthesis techniques for step-cut olecranon osteotomy
title_sort	biomechanical study comparing the mean load to failure of two different osteosynthesis techniques for step-cut olecranon osteotomy
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/09c17134782345ee9c6a8e71c846fa7f
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A biomechanical study comparing the mean load to failure of two different osteosynthesis techniques for step-cut olecranon osteotomy

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