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Is the novel olecranon tension plate a valid alternative to tension band wiring of olecranon fractures? A biomechanical study on cadaver bones

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Tension band wiring (TBW) used for olecranon fractures is afflicted with a high rate of complications. The aim of this study was to compare the stability of the TBW versus an alternative, novel low-profile olecranon tension plate (OTP) with angular stable screws in a simulated complex fracture model.

Materials and methods

Nine fresh-frozen pairs of cadaver proximal ulnae with an oblique osteotomy and an additional wedge fragment simulating an unstable fracture were tested. The TBW and OTP were implanted pairwise. The elbow motion was simulated in a single-muscle model and ranged from full extension to 90° of flexion. The pulling force of the triceps tendon ranged from 50 to 200 N. The displacement of the fracture fragments was measured with a video motion analysis system over 304 cycles. Data were assessed statistically using the Wilcoxon signed-rank test.

Results

The cyclic loading tests showed mean loosening of the fracture fragments at the articular surface of 0.56 mm using TBW (SD 0.65) and 0.15 mm for OTP (SD 0.39). There was no statistical significance in loosening between the two constructs (p = 0.31). No plate breakage or screw loosening occurred.

Conclusions

The low-profile OTP, using the principles of pre-tensioning, lag, cortical, and angular stable screws together, demonstrated similar stability after olecranon fracture fixation when compared with the TBW technique and a lag screw in the olecranon fracture model with a third wedge fragment.

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Acknowledgements

This manuscript is based on the analysis of data included in the Dr. Med. Thesis of CA.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, University Medical Center of Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany

    Dominik Gruszka, Charlotte Arand, Julia Greenfield, Tobias E. Nowak, Raphael Kuechle, Sebastian Kuhn & Pol M. Rommens

  2. GRESPI EA 4694, Faculty of Sport Sciences, University of Reims Champagne-Ardenne, Reims, France

    Julia Greenfield

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  1. Dominik Gruszka
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  2. Charlotte Arand
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  3. Julia Greenfield
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  7. Pol M. Rommens
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Correspondence to Dominik Gruszka.

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Conflict of interest

The biomechanical laboratory of the Department of Trauma Surgery is supported by a yearly grant from Medartis AG, Basel, Switzerland. No direct benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this study by any of the authors.

Ethical approval

Written approval from the Ethics Committee of the Landesaerztekammer of Rhineland-Palatinate, Mainz, Germany (Approval No. 837.088.07 from 03 April 2007).

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Gruszka, D., Arand, C., Greenfield, J. et al. Is the novel olecranon tension plate a valid alternative to tension band wiring of olecranon fractures? A biomechanical study on cadaver bones. Arch Orthop Trauma Surg 137, 1651–1658 (2017). https://doi.org/10.1007/s00402-017-2760-5

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