Kurzfassung

The high complication rate of a tension band wiring (TBW) used for the internal fixation of olecranon fractures remains a disadvantage. The aim of this following study was to compare the stability of the TBW versus a novel olecranon tension plate (OTP) in a simulated fracture model. The model chosen in this study was more complex than in a previously finished study. 
We tested 9 fresh frozen-pairs of cadaver proximal ulnae with an oblique osteotomy and additional wedge fragment. The TBW...The high complication rate of a tension band wiring (TBW) used for the internal fixation of olecranon fractures remains a disadvantage. The aim of this following study was to compare the stability of the TBW versus a novel olecranon tension plate (OTP) in a simulated fracture model. The model chosen in this study was more complex than in a previously finished study. 
We tested 9 fresh frozen-pairs of cadaver proximal ulnae with an oblique osteotomy and additional wedge fragment. The TBW and OTP were implanted pairwise. The elbow motion ranged from full extension to 90 degrees of flexion, and the pulling force of the triceps tendon ranged from 50 N to 250 N.  The displacement of the fracture fragments was continuously measured with a video motion analysis system over 304 cycles. Data were assessed statistically using the Wilcoxon signed-rank test. P < 0.05 was considered statistically significant. All test pairs successfully completed the whole testing procedure that consisted of 304 cycles. There was no case of slippage of the sutures around the triceps. The gap directly meeting the cartilage surface of humeroulnar joint was taken into statistical consideration as the joint congruence is the most relevant factor for satisfying clinical results. Considering the overall loosening during the whole motion cycle, OTP showed 0,17mm displacement in comparison to 0.37 mm in TBW. The difference was not statistically significant with p=0.31.
This study shows that after 300 cycles of simulated elbow flexion, the tension plate is more stable for this type of fracture than the tension band wiring technique. However, the use of a lag screw connecting fragments 2 and 3 adds much support to this fracture. The better performance of the tension plate is thought to be due to an increase in material used which allows for a better force transmission. We believe that the tension plate should be strongly considered as a fixation method for these types of fractures.» weiterlesen» einklappen