Universität zu Köln

Hockmann, Jan Philipp ORCID: 0000-0002-6408-1415, Heck, Vincent ORCID: 0000-0002-2541-6032, Theißen, Niklas, Prescher, Andreas ORCID: 0000-0002-8241-5351, Leschinger, Tim ORCID: 0000-0003-1319-6949, Müller, Lars Peter ORCID: 0000-0001-9769-6865 and Hackl, Michael ORCID: 0000-0002-6183-5621 (2025). Bone graft augmentation of comminuted radial neck fractures improves the initial stability of plate fixation. A biomechanical study. Journal of Shoulder and Elbow Surgery, 34 (10). e906-e912. Elsevier. ISSN 1058-2746

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Abstract

Background: Using modern implants, even complex radial head and neck fractures can often be reconstructed. However, metaphyseal comminution is associated with delayed bone healing and an increased risk for loss of reduction. Hence, this biomechanical in-vitro study intended to evaluate the mechanical stability of a bone graft from the ipsilateral proximal ulna in plate fixation of comminuted radial neck fractures. Methods: Osteotomies at the level of the radial neck with a 3 mm defect were created on 20 fresh-frozen proximal radius specimens to simulate metaphyseal comminution. Fixation was performed with a locking radial head plate in group A and with an additional structural bone graft from the ipsilateral ulna in group B. Cyclic loading from 5-100 N was performed and axial displacement and stiffness were evaluated. Results: The axial displacement was larger in group A (0.81 ± 0.24 mm) than in group B (0.52 ± 0.27 mm) (P = .02). Group B had a higher axial stiffness compared to group A (300 (127-958) N/mm vs. 163 (82-209) N/mm, P = .015). Conclusion: In the case of metaphyseal comminution of radial head/neck fractures, additional bone graft augmentation from the proximal ulna results in significantly increased stability of locking plate fixation. Future clinical research should focus on whether this leads to improved union rates of these challenging fractures.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Hockmann, Jan Philipp UNSPECIFIED https://orcid.org/0000-0002-6408-1415 UNSPECIFIED Heck, Vincent UNSPECIFIED https://orcid.org/0000-0002-2541-6032 UNSPECIFIED Theißen, Niklas UNSPECIFIED UNSPECIFIED UNSPECIFIED Prescher, Andreas UNSPECIFIED https://orcid.org/0000-0002-8241-5351 UNSPECIFIED Leschinger, Tim UNSPECIFIED https://orcid.org/0000-0003-1319-6949 UNSPECIFIED Müller, Lars Peter UNSPECIFIED https://orcid.org/0000-0001-9769-6865 UNSPECIFIED Hackl, Michael UNSPECIFIED https://orcid.org/0000-0002-6183-5621 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-796903
Identification Number:	10.1016/j.jse.2025.01.032
Journal or Publication Title:	Journal of Shoulder and Elbow Surgery
Volume:	34
Number:	10
Page Range:	e906-e912
Number of Pages:	1
Date:	October 2025
Publisher:	Elsevier
ISSN:	1058-2746
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Orthopädie > Klinik und Poliklinik für Orthopädie und Unfallchirurgie
Subjects:	Medical sciences Medicine
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/79690