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- Title
Minimally invasive stabilization of distal humerus fractures: a pilot study with biomechanical evaluation.
- Authors
Reising, K.; Konstantinidis, L.; Helwig, P.; Wagner, F.C.L.; Südkamp, N.P.; Strohm, P.C.; Südkamp, N P
- Abstract
<bold>Background: </bold>Fracture of the distal humerus is a fairly rare injury and makes high demands on the treating surgeon. Prerequisites for a good outcome are anatomical reconstruction and osteosynthesis stable enough for exercises. A method permitting early restoration of function is especially important for patients with osteoporosis. The extensive surgical approach necessary for open reduction is associated with a high number of wound healing disorders and infections with a frequency of 11% being reported in the literature. Although open reduction and internal fixation in double-plating technique is unavoidable for complex intraarticular fractures, an alternative, minimally invasive and, consequently, tissue-preserving procedure is desirable for simpler fractures.<bold>Objectve: </bold>To investigate this issue further an angular stable nail system developed for the distal radius was implanted as a stabilizer and the construct tested biomechanically as part of a feasibility study.<bold>Methods: </bold>Distal humerus fractures were stabilized by insertion of a distal radius nail, namely, the Targon DR (Aesculap, Tuttlingen) and a K-wire. To test the hypothesis six cadaveric bones fixed in formalin were tested biomechanically for displacement, implant failure, and stiffness. Displacement was determined by means of an ultrasound-based system.<bold>Results: </bold>An average displacement of 1.6 mm ± 0.7 was recorded at a maximum compression force of 100 N in extension and an average displacement of 1.4 mm ± 0.9 in flexion. Implant failure was not observed for any of the constructs.<bold>Conclusions: </bold>The study presented here permits the conclusion that a minimally invasive procedure is possible at the distal humerus and does ensure adequate stability. Although the nail was not specifically designed for the humerus, current findings form the basis for a promising approach that will be pursued further after modification of the nail design.
- Subjects
HUMERUS injuries; INTERNAL fixation in fractures; WOUND healing; DIAGNOSTIC ultrasonic imaging; OSTEOPOROSIS; PATIENTS; MINIMALLY invasive procedures; FRACTURE fixation; BONE fractures; MECHANICS (Physics); ORTHOPEDIC implants; PILOT projects
- Publication
Technology & Health Care, 2014, Vol 22, Issue 6, p909
- ISSN
0928-7329
- Publication type
journal article
- DOI
10.3233/THC-140864