Standardized fracture creation in the distal humerus and the olecranon for surgical training and biomechanical testing

Abstract Introduction Surgical training and biomechanical testing require models that realistically represent the in vivo injury condition. The aim of this work was to develop and test a method for the generation of distal humerus fractures and olecranon fractures in human specimens, while preserving the soft tissue envelope. Methods Twenty-one cadaveric upper extremity specimens (7 female, 14 male) were used. Two different experimental setups were developed, one to generate distal humerus fractures and one to generate olecranon fractures. Specimens were placed in a material testing machine and fractured with a predefined displacement. The force required for fracturing and the corresponding displacement were recorded and the induced energy was derived of the force–displacement graphs. After fracturing, CT imaging was performed and fractures were classified according to the AO classification. Results Eleven distal humerus fractures and 10 olecranon fractures with intact soft tissue envelope could be created. Distal humerus fractures were classified as AO type C (n = 9) and as type B (n = 2), all olecranon fractures were classified as AO type B (n = 10). Distal humerus fractures required significantly more load than olecranon fractures (6077 N ± 1583 vs 4136 N ± 2368, p = 0.038) and absorbed more energy until fracture than olecranon fractures (17.8 J ± 9.1 vs 11.7 J ± 7.6, p = 0.11), while the displacement at fracture was similar (5.8 mm ± 1.6 vs 5.9 mm ± 3.1, p = 0.89). Conclusion The experimental setups are suitable for generating olecranon fractures and distal humerus fractures with intact soft tissue mantle for surgical training and biomechanical testing.

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Long-Term Functional Outcomes and Complications of Intra-Articular (AO type B, C) Distal Humerus Fractures in Adults: A Retrospective Review

Cureus ◽

10.7759/cureus.21094 ◽

2022 ◽

Author(s):

Minos Tyllianakis ◽

Konstantina Solou ◽

John Lakoumentas ◽

Andreas Panagopoulos

Keyword(s):

Retrospective Review ◽

Functional Outcomes ◽

Distal Humerus ◽

Type B ◽

Humerus Fractures ◽

Distal Humerus Fractures

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FUNCTIONAL OUTCOME OF DISTAL HUMERUS FRACTURE BY PARATRICEPITAL TWO WINDOW APPROACH

10.36106/ijsr/6516805 ◽

2021 ◽

pp. 57-58

Author(s):

Chhatrapal Singh ◽

R.S. Bajoria ◽

Arvind ambedkar ◽

Sourabh Alawa

Keyword(s):

Soft Tissue ◽

Functional Outcome ◽

Distal Humerus ◽

Humerus Fracture ◽

Distal Humerus Fracture ◽

Excellent Functional Outcome ◽

Humerus Fractures ◽

Distal Humerus Fractures ◽

Window Approach

Background-Most of distal humerus fractures are dealt with olecranon osteotomy approach which stand as cumbersome process resulting in excessive soft tissue damage and excess hardware interposition. Alternate paratricepital two window approach has been advocated by many authors as better approach to deal with AO type A, B, and C1 type distal humerus fractures. AIM -To evaluate functional outcome of distal humerus fracture xation through paratricepital two window approach Materials & Methods – A complete of 30 patients of closed fracture distal humerus fracture underwent open fracture xation through paratricepital approach. Average age of patient was 35yr .Regular follow up and physiotherapy sessions were carried out. Average period of follow up was 12 month. Results – Out of 30 patients 28 were nally followed up till 1 year, one patient died in between while another one undergoes implant removal due to infection. From 28, 20 patients has excellent functional outcome, 3 has good, 4 has fair outcome and one patient has poor results in terms of MEPS and DASH score. Conclusion – Based on present study and data analysis we conclude that distal humerus fracture treated through paratricepital two window approach results in excellent functional outcome which is evident from ability to early start various day to day to day activities like performing st nd personal hygiene, combing hairs ,putting shirt- shoes themselves and starts eating themselves by 1 or 2 week of surgery .Unlike traditional approach like Olecranon osteotomy , it maintains adequate Tricep extensor mechanism ,does minimal soft tissue damage ,minimal post op pain ,promote early wound healing and avoid excessive hardware transposition

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Open or Closed Pinning for Distal Humerus Fractures in Children?

Swiss Surgery ◽

10.1024/1023-9332.9.2.76 ◽

2003 ◽

Vol 9 (2) ◽

pp. 76-81 ◽

Cited By ~ 12

Author(s):

de Buys Roessingh ◽

Reinberg

Keyword(s):

Distal Humerus ◽

Neurological Involvement ◽

Cubitus Varus ◽

Cubitus Valgus ◽

Fractures In Children ◽

Motor Deficiency ◽

Humerus Fractures ◽

Distal Humerus Fractures ◽

With Screws ◽

Length Of Hospitalization

Introduction: In children, the choice between percutaneous pinning (PP) and open pinning fixation (OPF) for the surgical treatment of fractures of the distal humerus remains controversial, especially the PP method for internal humeral condylar (IHC) fractures. Patients and methods: Eighty fractures of the distal humerus in children were treated surgically in our hospital over a ten year period. 47% (n = 38) were supracondylar (SC), 20% (n = 16) comminuted (COM), 18% (n = 14) internal humeral condylar (IHC), and 15% (n = 12) lateral humeral condylar (LHC). We used PP, OPF and three times osteosynthesis with screws. Results: In comparison to OPF, PP reduced the length of hospitalization in SC fractures (2.8 versus 6.1 days) and IHC fractures (2.4 versus five days). It reduced the risk of extension deficiency (11.1% versus 15%) and of cubitus valgus (0% versus 20%) in SC fractures, and of cubitus varus in IHC fractures (0% versus 11.1%). However it induced a higher rate of cubitus valgus (11.1% versus 20%) in IHC fractures, one persistent neurological motor deficiency (radial nerve) and four cases of transitional neurological involvement (ulnar nerve). Conclusions: PP is a good surgical method for SC and for also for IHC fractures, if performed by experienced surgeons so as to avoid neurological damage.

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