Department of Orthopaedics and Trauma Surgery, Hospital San José – Clínica Santa María, Santiago, Chile
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Shoulder, Elbow Unit, Sportsclinicnumber1, Bern, Switzerland
Shoulder, Elbow and Orthopaedic Sports Medicine, Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, Bern, Switzerland
Campus Stiftung Lindenhof Bern, Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
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with open reduction and internal fixation, generally either conservative treatment or arthroplasty is preferred. Stiffness after PHF develops in a significant proportion of patients, even in undisplaced fractures managed conservatively ( 3 ). PHFs
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, as they provide angular stability and theoretically a more rigid construct due to the head-locking mechanism. 21 However, biomechanical studies have shown no significant difference in stiffness between locking and traditional compression plates
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primary goal of surgical treatment to regain an unrestricted elbow function. Thus, the surgeon carefully needs to address all aspects of the injury to allow early (active) rehabilitation and thereby prevent elbow stiffness. 4 An improper osseous
Department of Orthopaedics and Traumatology, Freiburg University Hospital, Freiburg, Germany.
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for decision-making. A hypertrophic nonunion is stiff, has abundant callus and viable fracture fragments. Therefore, the biology is more than adequate, however, the mechanical instability prevents maturation and consolidation. An oligotrophic nonunion
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, 15 , 16 ), comminuted articular fractures (type 33C) ( 17 , 18 , 19 ), and periprosthetic distal femoral fractures ( 20 ). Fontenot et al. ( 17 ) reported a 70% significant increase in stiffness under axial load when a medial construction plate
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or nonunion, knee stiffness, prolonged hospitalisation and inability to bear weight. 39 The functional assessment after treatment of floating knee injuries is evaluated by most authors using the Karlström and Olerud grading system ( Table 2
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transmits about 90% of forces during axial loading through the forearm and contributes by 75% to its mechanical stiffness. Moreover, the CB accommodates load transmission from the distal radius to the proximal ulna; the radiocarpal joint carries
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allow the patient to weight-bear early, thus facilitating early post-operative rehabilitation and prevention of stiffness. When the joint surface is involved, anatomical restoration of the surface is of paramount importance to eliminate the risk of a
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biomechanical strength and stiffness of two-hole and four-hole DHS constructs used for the fixation of unstable trochanteric fractures (equivalent to AO-OTA 31-A2 fractures) created in cadaveric femora. 39 They found that the two-hole DHS was
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endosteum), to fewer, stiffer perpendicular and oblique fibres in old bone, 24 rendering it more susceptible to damage by distraction or torsion. The cambial lamina of the periosteum generates bone when the tension placed on it is reduced. 25
