Dittman Lauren E, Hinchcliff Katharine M, Hooke Alexander W, Kakar Sanjeev
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
Biomechanics Core, Mayo Clinic, Rochester, MN, USA.
Hand (N Y). 2024 Feb 26:15589447241233707. doi: 10.1177/15589447241233707.
To determine the amount of micromotion during forearm rotation after diaphyseal ulnar shaft fracture or osteotomy.
This was a biomechanical study using 7 paired-matched cadavers. The upper extremity was mounted in a custom rig and the forearm brought through full pronation and supination. A Hall effect sensor was placed at the fracture ends to measure micromotion for all tested conditions. There were 4 conditions tested: (1) intact ulnar shaft with plate to act as a control; (2) transverse fracture/osteotomy without stabilization; (3) fracture/osteotomy with cortical apposition stabilized with plate fixation; and (4) 50% comminuted fracture stabilized with plate.
There was a significantly greater amount of fracture site motion in the fracture/osteotomy model without stabilization compared with all other tested conditions ( < .001, .0001, .0003, respectively). The fracture/osteotomy site with cortical apposition and the comminuted fracture models showed no statistically significant differences in the amount of micromotion compared with each another ( = .952) or compared with the intact ulnar shaft ( = .997, .889, respectively).
There was no significant difference in the amount of motion between an intact ulnar shaft, an ulnar shaft fracture with cortical apposition stabilized with a plate, and a plated comminuted fracture. These findings may help surgeons decide on their type of postoperative immobilization in the setting of isolated ulnar shaft fractures or ulnar shaft osteotomies stabilized with plate fixation.
确定尺骨干骨折或截骨术后前臂旋转过程中的微动程度。
这是一项使用7对匹配尸体的生物力学研究。将上肢安装在定制装置上，使前臂进行全旋前和旋后动作。在骨折端放置一个霍尔效应传感器，以测量所有测试条件下的微动情况。共测试4种情况：（1）完整尺骨干加钢板作为对照；（2）无固定的横行骨折/截骨；（3）通过钢板固定使皮质骨对位的骨折/截骨；（4）用钢板固定的50%粉碎性骨折。
与所有其他测试条件相比，无固定的骨折/截骨模型中骨折部位的运动明显更多（分别为P<0.001、P<0.0001、P<0.0003）。皮质骨对位的骨折/截骨部位和粉碎性骨折模型在微动程度上彼此之间（P = 0.952）或与完整尺骨干相比（分别为P = 0.997、P = 0.889）均无统计学显著差异。
完整尺骨干、用钢板固定使皮质骨对位的尺骨干骨折以及钢板固定的粉碎性骨折在运动程度上无显著差异。这些发现可能有助于外科医生在单纯尺骨干骨折或用钢板固定的尺骨干截骨情况下决定术后固定类型。
