Moon Morgan, Schweser Kyle, Bezold Will, Cook James L
Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA.
Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, MO, USA.
J Orthop. 2022 Sep 28;34:316-321. doi: 10.1016/j.jor.2022.09.015. eCollection 2022 Nov-Dec.
Tension band wiring (TBW) is considered the 'gold standard' for fixation of transverse olecranon fractures (OTA/AO 2U1B1d). However, this approach requires a large exposure, can be technically demanding and operator-dependent, and is associated with hardware prominence. Continuous compression implants (CCI) may address these limitations. To the authors' knowledge, a comparison between TBW and CCI has not been performed. Therefore, this study was designed to compare biomechanical properties of CCI to TBW for 2U1B1d olecranon fractures using human cadaver elbows.
A transverse olecranon fracture was simulated in eight matched pairs of cadaveric elbows. Matched pairs were used for comparison of TBW and CCI. Cyclic loading was performed at both 10 N and 500 N, with gap formation and load to failure recorded. Results: No significant difference in gap formation at 10 N (p > 0.3) or 500 N (p = 0.6), or load-to-failure (p=.00.41), was observed between the two groups.
CCI fixation requires a smaller incision, is easy to perform, and involves low-profile implant that may reduce morbidity. Based on biomechanical properties that match the gold standard, continuous compression nitinol implants are an appropriate option for fixation of transverse olecranon fractures with potential advantages over tension band wiring.
张力带钢丝固定术（TBW）被认为是横行鹰嘴骨折（OTA/AO 2U1B1d）固定的“金标准”。然而，这种方法需要较大的暴露范围，技术要求高且依赖术者，并且与内固定物突出有关。持续加压植入物（CCI）可能解决这些局限性。据作者所知，尚未对TBW和CCI进行比较。因此，本研究旨在使用人体尸体肘部比较CCI和TBW对2U1B1d型鹰嘴骨折的生物力学特性。
在八对匹配的尸体肘部模拟横行鹰嘴骨折。匹配的对用于比较TBW和CCI。在10 N和500 N下进行循环加载，记录间隙形成和破坏载荷。结果：两组在10 N（p>0.3）或500 N（p = 0.6）时的间隙形成或破坏载荷（p = 0.41）均无显著差异。
CCI固定需要较小的切口，易于操作，并且涉及低轮廓植入物，这可能会降低发病率。基于与金标准相匹配的生物力学特性，持续加压镍钛诺植入物是固定横行鹰嘴骨折的合适选择，与张力带钢丝固定相比具有潜在优势。
