The effect of humeral-fenestration diameter in Outerbridge–Kashiwagi arthroplasty on failure load of the distal humerus: a cadaveric biomechanical study
Journal
Archives of Orthopaedic and Trauma Surgery
Journal Volume
138
Journal Issue
5
Start Page
623-628
ISSN
0936-8051
1434-3916
Date Issued
2018-01-22
Author(s)
Abstract
Introduction: Outerbridge-Kashiwagi ulnohumeral arthroplasty is an effective method in treating elbow osteoarthritis; however, distal humerus fracture after surgery can become a critical issue. A previous biomechanical study has shown that the failure load of the distal humerus decreases after a fenestration, but the size of the fenestration hole has not yet been discussed.
Materials and methods: 32 fresh-frozen cadaveric distal humeri were obtained. Two drill sizes were chosen for fenestration: 12 and 15 mm in diameter. Two directions of force were applied with a materials testing machine for biomechanical testing: 5° flexion for axial loading and 75° flexion for anterior-posterior (AP) loading. Each specimen randomly received one of the two fenestration sizes, and force directions. All specimens were loaded to failure at a rate of 2 mm/min.
Results: The failure loads of the 12 and 15 mm groups were not significantly different in either axial loading(3886 ± 1271 N vs 4286 ± 901 N) or AP loading(2303 ± 803 N vs 1897 ± 357 N). All specimens loaded with axial force failed via the fenestration holes; however, during AP loading, some specimens failed through the fenestration holes, while others at diaphysis (p = 0.28).
Conclusions: The failure load of distal humeri did not differ significantly after fenestration of 12 or 15 mm. The clinical relevance is that as the risk of distal humerus fracture is not exacerbated, a larger-size fenestration hole could be of help to improve the effectiveness of this surgical procedure.
Subjects
Distal humerus
Fenestration
Outerbridge–Kashiwagi
Ulnohumeral arthroplasty
SDGs
Publisher
Springer Science and Business Media LLC
Type
journal article