Abstract
BackgroundComminuted proximal ulna fractures are severe injuries with a high degree of instability. These injuries require surgical treatment, usually angular stable plating or double plating is performed. Nailing of proximal ulna fracture is described but not performed regularly. The aim of this study was to compare a newly developed, locked proximal ulna nail with an angular stable plate in an unstable fracture of the proximal ulna. We hypothesize, that locked nailing of the proximal ulna will provide non-inferior stability compared to locked plating.MethodsA defect fracture distal to the coronoid was simulated in 20 sawbones. After nailing or plate osteosynthesis the constructs were tested in a servo-pneumatic testing machine under physiological joint motion (0°-90°) and cyclic loading (30 N – 300 N). Intercyclic osteotomy gap motion and plastic deformation of the constructs were analyzed using micromotion video-analysis.ResultsThe locked nail showed lower osteotomy gap motion (0.50 ± 0.15 mm) compared to the angular stable plate (1.57 ± 0.37 mm, p < 0.001). At the anterior cortex the plastic deformation of the constructs was significantly lower for the locked nail (0.09 ± 0.17 mm vs. 0.39 ± 0.27 mm, p = 0.003). No statistically significant differences were observed at the posterior cortex for both parameters.ConclusionsNail osteosynthesis in comminuted proximal ulna fractures shows lower osteotomy gap motion and lower amount of plastic deformation compared to locking plate osteosynthesis under laboratory conditions.
Highlights
Comminuted proximal ulna fractures are severe injuries with a high degree of instability
Our results confirm our hypothesis of sufficient primary stability of the nail in highly unstable fracture patterns of the proximal ulna in laboratory conditions
Locked nailing of unstable proximal ulna fractures provides low osteotomy gap motion and a low rate of plastic deformation compared to locked plating
Summary
Comminuted proximal ulna fractures are severe injuries with a high degree of instability These injuries require surgical treatment, usually angular stable plating or double plating is performed. In case of a comminuted proximal ulna fracture the osteosynthesis must provide a high amount of stability to allow bony healing. Intramedullary implants are available for fracture fixation of the proximal ulna and show promising biomechanical and clinical results, but are not used regularly in clinical practice [9, 10]. These implants can theoretically reduce disadvantages and complications of plate osteosynthesis due to a
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have