Degreef I, Van Audekercke R, Boogmans T, De Smet L
Orthopaedic department, hand unit, orthopaedic surgery, university hospitals Leuven, Pellenberg campus, Weligerveld, Belgium.
Chir Main. 2011 Jun;30(3):183-7. doi: 10.1016/j.main.2011.03.001. Epub 2011 Apr 20.
In the Outerbridge-Kashiwagi ulnohumeral arthroplasty, bone strength may be weakened significantly as a result of the humeral fenestration. Therefore, fracture risks may be increased, particularly in the immediate postoperative period. The objective of this biomechanical cadaver study is to study the humeral bone strength after ulnohumeral arthroplasty. A biomechanical cadaveric study was done in which differences in force needed to fracture the humerus with and without fenestration was measured. First, the diaphysis of 12 distal humeri was embedded and a posterior force was applied until a fracture occurred. Second, a similar study was done with fixed humeral columns, to specifically compare the column strength. In the first part, the force needed to fracture was reduced by 17% after ulnohumeral arthroplasty, which was not statistically significant. However, a shift in the fracture pattern occurred: from diaphyseal fracture towards column fractures after the arthroplasty. In the second part, the force needed to fracture the columns proved to be significantly reduced by 41% after humeral perforation. Alterations in the biomechanical properties of the distal humerus after ulnohumeral arthroplasty may lead to a shift in fracture patterns from diaphyseal to column fractures. The strength of the columns is strongly reduced by 41%.
在奥尔特布里奇-柏木式尺肱关节置换术中，由于肱骨开窗，骨强度可能会显著减弱。因此，骨折风险可能会增加，尤其是在术后即刻。本生物力学尸体研究的目的是研究尺肱关节置换术后的肱骨骨强度。进行了一项生物力学尸体研究，测量了有开窗和无开窗情况下肱骨骨折所需力的差异。首先，将12根肱骨远端骨干嵌入并施加向后的力，直至发生骨折。其次，对固定的肱骨柱进行了类似研究，以具体比较柱强度。在第一部分中，尺肱关节置换术后骨折所需的力降低了17%，但无统计学意义。然而，骨折模式发生了转变：置换术后从骨干骨折转变为柱骨折。在第二部分中，肱骨穿孔后柱骨折所需的力被证明显著降低了41%。尺肱关节置换术后肱骨远端生物力学特性的改变可能导致骨折模式从骨干骨折转变为柱骨折。柱强度大幅降低了41%。
