The simulation of terrible triad injuries in fresh-frozen human cadaveric specimens with intact soft tissue envelope

Lanzerath, Fabian ORCID: 0000-0002-4780-6875, Knifka, Jutta, Leschinger, Tim, Ott, Nadine, Kahmann, Stephanie, Hackl, Michael, Muller, Lars P. and Wegmann, Kilian . The simulation of terrible triad injuries in fresh-frozen human cadaveric specimens with intact soft tissue envelope. Arch. Orthop. Trauma Surg.. NEW YORK: SPRINGER. ISSN 1434-3916

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DOI:10.1007/s00402-022-04677-x

Abstract

Introduction: The aim of the present study was to develop a technical process to reproducibly generate terrible triad injuries (TTI) in fresh-frozen human cadaveric specimens, while leaving the skin intact. Such pre-fractured specimens, used for scientific analysis and for surgical education, might help to improve current treatment, which is complex and prone to complications.Materials and methods: To induce the desired fractures, a custom-made fracturing unit was used to apply an axial force on the extended cadaveric elbow specimens, with the forearm pronated and under valgus load. To simulate the valgus load, a pneumatic cylinder was developed to apply valgus stress to the joint by an additional force vector from the lateral side of the joint.Results: The success rate of TTI induction was 92.3% (12/13). Of the 12 radial head fractures, 3 (25%) were classified Mason type II and 9 (75%) Mason type III. The coronoid fractures were grouped in tip subtype 2 (5 fractures, 41.7%), anteromedial facet (AMF) subtype 2 (4 fractures, 33.3%), AMF subtype 3 (1 fracture, 8.3%) and basal subtype 1 (2 fractures, 16.7%).Conclusions: The present study provides an instrument for successful and reproducible production of dislocation fracture patterns with their typical accompanying soft tissue lesions. The methodology might be applied on a broad basis to be able to perform biomechanical studies regarding primary stability of fixation concepts for TTI and to educate surgeons in a fairly realistic scenario with the surgical treatment of TTI.

Item Type:

Journal Article

Creators:

Creators	Email	ORCID	ORCID Put Code
Lanzerath, Fabian	UNSPECIFIED	orcid.org/0000-0002-4780-6875	UNSPECIFIED
Knifka, Jutta	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Leschinger, Tim	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Ott, Nadine	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Kahmann, Stephanie	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Hackl, Michael	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Muller, Lars P.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Wegmann, Kilian	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED