PMID- 26443882
OWN - NLM
STAT- MEDLINE
DCOM- 20160803
LR  - 20181202
IS  - 1879-1271 (Electronic)
IS  - 0268-0033 (Linking)
VI  - 30
IP  - 10
DP  - 2015 Dec
TI  - Extra-articular step osteotomy of the olecranon: A biomechanical assessment.
PG  - 1043-8
LID - S0268-0033(15)00250-8 [pii]
LID - 10.1016/j.clinbiomech.2015.09.009 [doi]
AB  - BACKGROUND: Trans-olecranon chevron osteotomies (COs) remain the gold standard 
      surgical approach to type C fractures of the distal humerus. This technique is 
      associated with a high complication rate and development of an extra-articular 
      olecranon osteotomy may be advantageous. The aim of this study was to compare the 
      load to failure of COs with extra-articular oblique osteotomies (OOs) as well as 
      modified, extra-articular step osteotomies (SOs). METHODS: These three 
      osteotomies and their subsequent fixation utilizing a standardized tension band 
      wiring technique were tested in 42 composite analog ulnae models at 20 degrees  and 70 degrees  
      of flexion. Triceps loading was simulated with a servo hydraulic testing machine. 
      All specimens were isometrically loaded until failure. Kinematic and force data, 
      as well as interfragmentary motion were recorded. RESULTS: At 70 degrees , CO failed at a 
      mean load of 963 N (SD 104 N), the OO at 1512 N (SD 208 N) and the SO at 1484 N 
      (SD 153 N), (P<0.001). At 20 degrees , CO failed at a mean load of 707 N (SD 104 N) and 
      OO at 1009 N (SD 85 N) (P=0.006). The highest load to failure was observed for 
      the SO, which was 1277 N (SD 172 N). The load to failure of the SO was 
      significantly higher than the CO as well as the OO. CONCLUSION: Extra-articular 
      osteotomies showed a significantly higher load to failure in comparison to 
      traditional CO. At near full extension (20 degrees  of flexion), this biomechanical 
      advantage was further enhanced by a step-cut modification of the extra-articular 
      oblique osteotomy.
CI  - Copyright (c) 2015 Elsevier Ltd. All rights reserved.
FAU - Zumstein, Matthias A
AU  - Zumstein MA
AD  - Department of Orthopaedic Surgery and Traumatology, University of Bern, Insel 
      Hospital, Switzerland. Electronic address: m.zumstein10@gmail.com.
FAU - Burki, Alexander
AU  - Burki A
AD  - Institute for Surgical Technology and Biomechanics, University of Berne, 
      Stauffacherstrasse 78, Bern, Switzerland.
FAU - Massy, Anne-Sophie
AU  - Massy AS
AD  - Department of Orthopaedic Surgery and Traumatology, University of Bern, Insel 
      Hospital, Switzerland.
FAU - Zysset, Philippe
AU  - Zysset P
AD  - Institute for Surgical Technology and Biomechanics, University of Berne, 
      Stauffacherstrasse 78, Bern, Switzerland.
FAU - Moor, Beat K
AU  - Moor BK
AD  - Department of Orthopaedic Surgery and Traumatology, University of Bern, Insel 
      Hospital, Switzerland.
LA  - eng
PT  - Journal Article
DEP - 20150916
PL  - England
TA  - Clin Biomech (Bristol, Avon)
JT  - Clinical biomechanics (Bristol, Avon)
JID - 8611877
SB  - IM
MH  - Biomechanical Phenomena
MH  - Elbow Joint/physiopathology/surgery
MH  - Equipment Failure Analysis
MH  - Fracture Fixation, Internal/*methods
MH  - Humans
MH  - Humeral Fractures/physiopathology/*surgery
MH  - Models, Biological
MH  - Olecranon Process/*surgery
MH  - Osteotomy/*methods
MH  - Stress, Mechanical
MH  - Tensile Strength/physiology
MH  - Ulna/*injuries/physiopathology/surgery
OTO - NOTNLM
OT  - Elbow
OT  - Extensor mechanism
OT  - Olecranon osteotomy
OT  - Posterior approach
OT  - Triceps insertion
EDAT- 2015/10/08 06:00
MHDA- 2016/08/04 06:00
CRDT- 2015/10/08 06:00
PHST- 2015/04/24 00:00 [received]
PHST- 2015/09/09 00:00 [revised]
PHST- 2015/09/09 00:00 [accepted]
PHST- 2015/10/08 06:00 [entrez]
PHST- 2015/10/08 06:00 [pubmed]
PHST- 2016/08/04 06:00 [medline]
AID - S0268-0033(15)00250-8 [pii]
AID - 10.1016/j.clinbiomech.2015.09.009 [doi]
PST - ppublish
SO  - Clin Biomech (Bristol, Avon). 2015 Dec;30(10):1043-8. doi: 
      10.1016/j.clinbiomech.2015.09.009. Epub 2015 Sep 16.