The effect of humeral-fenestration diameter in Outerbridge–Kashiwagi arthroplasty on failure load of the distal humerus: a cadaveric biomechanical study

Chih Kai Hong, Ming-Long Yeh, I. Ming Jou, Cheng-Li Lin, Chih Hsun Chang, Chih Hung Chang, Wei-Ren Su

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)623-628
Number of pages6
JournalArchives of Orthopaedic and Trauma Surgery
Volume138
Issue number5
DOIs
Publication statusPublished - 2018 May 1

Fingerprint

Humerus
Arthroplasty
Weight-Bearing
Materials Testing
Diaphyses
Mandrillus
Elbow
Osteoarthritis
Direction compound

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

@article{d1e2a126a38a48d6859fd45708c3885b,
title = "The effect of humeral-fenestration diameter in Outerbridge–Kashiwagi arthroplasty on failure load of the distal humerus: a cadaveric biomechanical study",
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.",
author = "Hong, {Chih Kai} and Ming-Long Yeh and Jou, {I. Ming} and Cheng-Li Lin and Chang, {Chih Hsun} and Chang, {Chih Hung} and Wei-Ren Su",
year = "2018",
month = "5",
day = "1",
doi = "10.1007/s00402-018-2876-2",
language = "English",
volume = "138",
pages = "623--628",
journal = "Archiv fur orthopadische und Unfall-Chirurgie",
issn = "0003-9330",
publisher = "Springer Verlag",
number = "5",

}

The effect of humeral-fenestration diameter in Outerbridge–Kashiwagi arthroplasty on failure load of the distal humerus : a cadaveric biomechanical study. / Hong, Chih Kai; Yeh, Ming-Long; Jou, I. Ming; Lin, Cheng-Li; Chang, Chih Hsun; Chang, Chih Hung; Su, Wei-Ren.

In: Archives of Orthopaedic and Trauma Surgery, Vol. 138, No. 5, 01.05.2018, p. 623-628.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The effect of humeral-fenestration diameter in Outerbridge–Kashiwagi arthroplasty on failure load of the distal humerus

T2 - a cadaveric biomechanical study

AU - Hong, Chih Kai

AU - Yeh, Ming-Long

AU - Jou, I. Ming

AU - Lin, Cheng-Li

AU - Chang, Chih Hsun

AU - Chang, Chih Hung

AU - Su, Wei-Ren

PY - 2018/5/1

Y1 - 2018/5/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85040781667&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85040781667&partnerID=8YFLogxK

U2 - 10.1007/s00402-018-2876-2

DO - 10.1007/s00402-018-2876-2

M3 - Article

C2 - 29356940

AN - SCOPUS:85040781667

VL - 138

SP - 623

EP - 628

JO - Archiv fur orthopadische und Unfall-Chirurgie

JF - Archiv fur orthopadische und Unfall-Chirurgie

SN - 0003-9330

IS - 5

ER -