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12. Biomechanische und virtuelle Analyse von intramedullären Nägeln zur Versorgung von proximalen Humerusfrakturen

Author

Lenich, Andreas (Priv.-Doz. Dr.), Lenich, Andreas (Priv.-Doz. Dr.);Biberthaler, Peter (Prof. Dr.), Wanzl, Maximilian, Lenich, Andreas (Priv.-Doz. Dr.), Lenich, Andreas (Priv.-Doz. Dr.);Biberthaler, Peter (Prof. Dr.), and Wanzl, Maximilian

Abstract

4 verschiedene Marknägel zur Versorgung proximaler Humerusfrakturen wurden in einem biomechanischen Modell auf ihr Durchschneidverhalten hin untersucht. Dazu wurden die Marknägel in ein Knochenmodell implantiert und zyklisch belastet. Zudem wurde die Widerstandsfläche eines jeden Implantats virtuell analysiert, auf Korrelation zu den biomechanischen Versuchen untersucht. Ferner wurde die Winkelstabilität des PolyAxNails an einem Prüfstand mit physiologischer muskulärer Krafteinleitung validiert., 4 different intramedullary nails for the treatment of proximal humerus fractures underwent biomechanical testing regarding their cutting-through behavior. They were implanted in a bone like model and subjected to cyclic loading. In addition, the surface of resistancy of each implant was virtually analyzed and examined for correlation to the biomechanical tests. Furthermore, the angular stability of the PolyAxNail was validated on a test rig with physiological muscular force application.

Published
2023

13. Sports Injuries in Throwing Athletes

Author

Zupanc, Oskar, Holzer, Nicolas, Rosso, Claudio, Hilgersom, Nick F. J., Oh, Luke S., Lenich, Andreas, Hollinger, Boris, Uroš, Meglič, Eygendaal, Denise, Barco, Raul, Arrigoni, Paolo, Brioschi, Marco, Randelli, Pietro, Cucchi, Davide, Cift, Hakan Turan, Kerkhoffs, Gino M. M. J., editor, Haddad, Fares, editor, Hirschmann, Michael T., editor, Karlsson, Jón, editor, and Seil, Romain, editor

Published
2018
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26. Tendons

Author

Plath, Johannes E., Vogt, Stephan, Lenich, Andreas, Imhoff, Andreas B., editor, and Feucht, Matthias J., editor

Published
2015
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31. Sehnen

Author

Plath, Johannes, Lenich, Andreas, Vogt, Stephan, Imhoff, Andreas B., editor, and Feucht, Matthias J., editor

Published
2013
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36. Influence of Radial Head Prosthetic Design on Humeroradial Stability: Validation of a Test Rig therefore

Author

Eger, Maximilian, Bergsträßer, Marcel, Dendorfer, Sebastian, Lenich, Andreas, and Pfeifer, Christian

Subjects
Medicine and health, humeroradial stability, radial head prostheses, subluxation, radial head arthroplasty
Abstract

Objectives: Elbow injuries are a very common issue. In case of fractures and degenerative changes, a radial head prosthesis (RHP) is often used for treatment. One of the main problems with these implants is the high revision rate, with physiological subluxation being one of the reasons. Therefore, OT [for full text, please go to the a.m. URL]

Published
2022
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44. Modified anteromedial and anterolateral elbow arthroscopy portals show superiority to standard portals in guiding arthroscopic radial head screw fixation

Author

Cucchi, Davide, Arrigoni, Paolo, Luceri, Francesco, Menon, Alessandra, Guerra, Enrico, Müller, Lars Peter, Burger, Christof, Eygendaal, Denise, Wegmann, Kilian, Pederzini, Luigi, Çift, Hakan Turan, Holzer, Nicolas, Hollinger, Boris, Rosso, Claudio, van den Bekerom, Michel, Barco, Raul, Lenich, Andreas, Zupanc, Oskar, Orthopedic Surgery and Sports Medicine, AMS - Fundamental Research, AMS - Sports & Work, APH - Personalized Medicine, APH - Quality of Care, and Graduate School

Subjects
Male, medicine.medical_treatment, Bone Screws, Elbow, Arthroscopy, Fracture Fixation, Internal, 03 medical and health sciences, Fixation (surgical), 0302 clinical medicine, Cadaver, medicine, Humans, Internal fixation, Orthopedics and Sports Medicine, Kirschner wire, Protractor, Aged, Orthodontics, 030222 orthopedics, Osteosynthesis, medicine.diagnostic_test, business.industry, Reproducibility of Results, 030229 sport sciences, Radius, medicine.anatomical_structure, Female, Surgery, Radial head fracture, Radius Fractures, business, Epiphyses, Bone Wires
Abstract

Purpose: Arthroscopic fixation of radial head radial head fractures is an appealing alternative to open reduction and internal fixation, which presents the advantage of minimal surgical trauma. The aim of this study was to evaluate if modifications to the standard anteromedial (AM) and anterolateral (AL) portals could allow screw placement for radial head fracture osteosynthesis closer to the plane of the radial head articular surface. Methods: Eight fresh-frozen specimens were prepared to mimic arthroscopic setting. Standard AL (ALst) and AM (AMst) and distal AL (ALdi) and AM (AMdi) portals were established. Eleven independent examiners were asked to indicate the optimal trajectory, when aiming to place a cannulated screw parallel to the radial head surface for radial head osteosynthesis. A three-dimensional digital protractor was used to measure the angle between the indicated position and a Kirschner wire placed parallel to the radial head articular surface (α). The Shapiro–Wilk normality test was used to evaluate the normal distribution of the samples. Means, standard deviations, and 95% confidence intervals (95% CI) were calculated for each portal. A coefficient of variation (CoV) was calculated to determine agreement among observers and intra-observer variability. Results: Mean α angles were 25.1 ± 11.5° for AMst, 13.8 ± 4.8° for AMdi, 17.1 ± 13.4° for ALst, -2.6 ± 9.2° for ALdi. No overlapping in the 95% CI of ipsilateral standard and distal portals was observed, indicating that the difference between these means was statistically significant. The distal portals showed smaller inter-observer CoV as compared to the standard ones (AMst: 10.0%; AMdi: 4.6%; ALst: 12.5%; ALdi: 10.6%). Intra-observer CoV was similar for all portals (AMst: 5.5%; AMdi: 6.1%; ALst: 7.7%; ALdi: 7.1%). Conclusions: The use of distal AM and AL portals permits to obtain α angles closer to the radial head articular surface than standard AM and AL portals. This is expected to allow screw placement in a flatter trajectory, which should correlate with a superior biomechanical performance of fixation. Good reproducibility of Kirschner wire placement from distal portals was observer among different examiners. Modifications to the standard AM and AL elbow arthroscopy portals allow to place screws for radial head fracture osteosynthesis in a position which should guarantee superior biomechanical performance of fixation.

Published
2019
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45. Tendons

Author

Plath, Johannes E., primary, Vogt, Stephan, additional, and Lenich, Andreas, additional

Published
2014
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