Biomechanical evaluation of the modified lasso technique.

IF 2.3 3区 医学 Q2 ORTHOPEDICS
Shelby Rider, Christopher Caldwell, Brad Chauvin, R Shane Barton, Kevin Perry, Giovanni Francesco Solitro
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引用次数: 0

Abstract

Background: The Terrible Triad of the elbow is a constellation of elbow dislocation, radial head fracture and coronoid process fracture. A common type of coronoid fracture documented with this triad is type II Regan-Morrey coronoid fractures. The preferred fixation method for this fracture type is the lasso technique, medial-lateral tunnel orientation being the traditional approach. Considering elbow anatomy, we saw an opportunity to potentially improve fixation by altering the suture lasso tunnel orientation to a proximal-distal orientation.

Hypothesis: Two tunnels in the proximal-distal direction would result in greater biomechanical stability as compared to the traditional lasso technique.

Material and methods: A type 2 Regan-Morrey fracture was created in 12 fresh frozen cadaveric elbows at 50% of the coronoid height using an oscillating saw. The humero-ulnar joint was placed in 0 degrees flexion then loaded at a rate of 10mm/min to failure.

Results: The control technique (medio-lateral tunnels) showed failure load of 150±81N that was not significantly different (p=0.825) than the 134±116N measured for the modified technique (distal-proximal tunnels). The portion of the load-displacement curve used to calculate stiffness was linear (R^2=0.94±0.04) with determination coefficients that did not differ between the two groups (p=0.351). For stiffness, we measured 17±13N/mm and 14±12N/mm respectively for control and modified techniques that did not result in a significant difference (p=0.674).

Conclusion: In this attempt to improve the shortcomings of the lasso technique, we found that changing from medio-lateral to proximal-distal drilling directions did not result in an appreciable biomechanical benefit.

Level of evidence: Basic science study; Biomechanics.

改良套索技术的生物力学评估
背景:肘部可怕的三联症是指肘关节脱位、桡骨头骨折和冠状突骨折。这种三联症常见的冠状突骨折类型是 II 型 Regan-Morrey 冠状突骨折。这种骨折类型的首选固定方法是套索技术,内外侧隧道方向是传统方法。考虑到肘部的解剖结构,我们认为有机会将缝合套索隧道的方向改为近端-远端方向,从而改善固定效果:假设:与传统套索技术相比,近端-远端方向的两个隧道将带来更大的生物力学稳定性:使用摆动锯在12个新鲜冷冻尸体肘部冠状面高度的50%处创建2型Regan-Morrey骨折。将肱骨-肘关节置于 0 度屈曲状态,然后以 10 毫米/分钟的速度加载至破坏:结果:对照组技术(内侧-外侧隧道)的破坏载荷为 150±81N,与改良组技术(远端-近端隧道)的 134±116N 相比无显著差异(p=0.825)。用于计算硬度的负荷-位移曲线部分呈线性(R^2 = 0.94±0.04),两组之间的确定系数无差异(p=0.351)。在刚度方面,我们测量到对照组和改良技术组的刚度分别为 17±13N/mm 和 14±12 N/mm,差异不大(p=0.674):结论:在这一改善套索技术缺陷的尝试中,我们发现将钻孔方向从内外侧改为近端-远端并没有带来明显的生物力学益处:基础科学研究;生物力学。
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来源期刊
CiteScore
5.10
自引率
26.10%
发文量
329
审稿时长
12.5 weeks
期刊介绍: Orthopaedics & Traumatology: Surgery & Research (OTSR) publishes original scientific work in English related to all domains of orthopaedics. Original articles, Reviews, Technical notes and Concise follow-up of a former OTSR study are published in English in electronic form only and indexed in the main international databases.
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