TY - JOUR A1 - Hackl, Michael A1 - Wegmann, Kilian A1 - Kahmann, Stephanie Lucina A1 - Heinze, Nicolai A1 - Staat, Manfred A1 - Neiss, Wolfram F. A1 - Scaal, Martin A1 - Müller, Lars P. T1 - Radial shortening osteotomy reduces radiocapitellar contact pressures while preserving valgus stability of the elbow JF - Knee Surgery, Sports Traumatology, Arthroscopy Y1 - 2017 U6 - http://dx.doi.org/10.1007/s00167-017-4468-z SN - 1433-7347 VL - 25 IS - 7 SP - 2280 EP - 2288 PB - Springer CY - Berlin ER - TY - GEN A1 - Hackl, Michael A1 - Wegmann, Kilian A1 - Kahmann, Stephanie Lucina A1 - Heinze, Nicolai A1 - Staat, Manfred A1 - Neiss, Wolfram F. A1 - Scaal, Martin A1 - Müller, Lars P. T1 - Reply to the letter to the editor: shortening osteotomy of the proximal radius T2 - Knee Surgery, Sports Traumatology, Arthroscopy Y1 - 2017 U6 - http://dx.doi.org/10.1007/s00167-017-4666-8 VL - 25 IS - 10 SP - 3328 EP - 3329 ER - TY - JOUR A1 - Meyer, Carolin A1 - Gaalen, Kerstin van A1 - Leschinger, Tim A1 - Scheyerer, Max J. A1 - Neiss, Wolfram F. A1 - Staat, Manfred A1 - Müller, Lars P. A1 - Wegmann, Kilian T1 - Kyphoplasty of Osteoporotic Fractured Vertebrae: A Finite Element Analysis about Two Types of Cement JF - BioMed Research International Y1 - 2019 U6 - http://dx.doi.org/10.1155/2019/9232813 SP - Article ID 9232813 ER - TY - JOUR A1 - Rausch, Valentin A1 - Harbrecht, Andreas A1 - Kahmann, Stephanie Lucina A1 - Fenten, Thomas A1 - Jovanovic, Nebojsa A1 - Hackl, Michael A1 - Müller, Lars P. A1 - Staat, Manfred A1 - Wegmann, Kilian T1 - Osteosynthesis of Phalangeal Fractures: Biomechanical Comparison of Kirschner Wires, Plates, and Compression Screws JF - The Journal of Hand Surgery N2 - Purpose The aim of this study was to compare several osteosynthesis techniques (intramedullary headless compression screws, T-plates, and Kirschner wires) for distal epiphyseal fractures of proximal phalanges in a human cadaveric model. Methods A total of 90 proximal phalanges from 30 specimens (index, ring, and middle fingers) were used for this study. After stripping off all soft tissue, a transverse distal epiphyseal fracture was simulated at the proximal phalanx. The 30 specimens were randomly assigned to 1 fixation technique (30 per technique), either a 3.0-mm intramedullary headless compression screw, locking plate fixation with a 2.0-mm T-plate, or 2 oblique 1.0-mm Kirschner wires. Displacement analysis (bending, distraction, and torsion) was performed using optical tracking of an applied random speckle pattern after osteosynthesis. Biomechanical testing was performed with increasing cyclic loading and with cyclic load to failure using a biaxial torsion-tension testing machine. Results Cannulated intramedullary compression screws showed significantly less displacement at the fracture site in torsional testing. Furthermore, screws were significantly more stable in bending testing. Kirschner wires were significantly less stable than plating or screw fixation in any cyclic load to failure test setup. Conclusions Intramedullary compression screws are a highly stable alternative in the treatment of transverse distal epiphyseal phalangeal fractures. Kirschner wires seem to be inferior regarding displacement properties and primary stability. Clinical relevance Fracture fixation of phalangeal fractures using plate osteosynthesis may have the advantage of a very rigid reduction, but disadvantages such as stiffness owing to the more invasive surgical approach and soft tissue irritation should be taken into account. Headless compression screws represent a minimally invasive choice for fixation with good biomechanical properties. Y1 - 2020 U6 - http://dx.doi.org/10.1016/j.jhsa.2020.04.010 SN - 0363-5023 VL - 45 IS - 10 SP - 987.e1 EP - 987.e8 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Rausch, Valentin A1 - Kahmann, Stephanie Lucina A1 - Baltschun, Christoph A1 - Staat, Manfred A1 - Müller, Lars P. A1 - Wegmann, Kilian T1 - Pressure distribution to the distal biceps tendon at the radial tuberosity: a biomechanical study JF - The Journal of Hand Surgery N2 - Purpose Mechanical impingement at the narrow radioulnar space of the tuberosity is believed to be an etiological factor in the injury of the distal biceps tendon. The aim of the study was to compare the pressure distribution at the proximal radioulnar space between 2 fixation techniques and the intact state. Methods Six right arms and 6 left arms from 5 female and 6 male frozen specimens were used for this study. A pressure transducer was introduced at the height of the radial tuberosity with the intact distal biceps tendon and after 2 fixation methods: the suture-anchor and the cortical button technique. The force (N), maximum pressure (kPa) applied to the radial tuberosity, and the contact area (mm²) of the radial tuberosity with the ulna were measured and differences from the intact tendon were detected from 60° supination to 60° pronation in 15° increments with the elbow in full extension and in 45° and 90° flexion of the elbow. Results With the distal biceps tendon intact, the pressures during pronation were similar regardless of extension and flexion and were the highest at 60° pronation with 90° elbow flexion (23.3 ± 53.5 kPa). After repair of the tendon, the mean peak pressure, contact area, and total force showed an increase regardless of the fixation technique. Highest peak pressures were found using the cortical button technique at 45° flexion of the elbow and 60° pronation. These differences were significantly different from the intact tendon. The contact area was significantly larger in full extension and 15°, 30°, and 60° pronation using the cortical button technique. Conclusions Pressures on the distal biceps tendon at the radial tuberosity increase during pronation, especially after repair of the tendon. Clinical relevance Mechanical impingement could play a role in both the etiology of primary distal biceps tendon ruptures and the complications occurring after fixation of the tendon using certain techniques. Y1 - 2020 U6 - http://dx.doi.org/10.1016/j.jhsa.2020.01.006 SN - 0363-5023 VL - 45 IS - 8 SP - 776.e1 EP - 776.e9 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Hackl, Michael A1 - Buess, Eduard A1 - Kammerlohr, Sandra A1 - Nacov, Julia A1 - Staat, Manfred A1 - Leschinger, Tim A1 - Müller, Lars P. A1 - Wegmann, Kilian T1 - A "comma sign"-directed subscapularis repair in anterosuperior rotator cuff tears yields biomechanical advantages in a cadaveric model JF - The american journal of sports medicine N2 - Background: Additional stabilization of the “comma sign” in anterosuperior rotator cuff repair has been proposed to provide biomechanical benefits regarding stability of the repair. Purpose: This in vitro investigation aimed to investigate the influence of a comma sign–directed reconstruction technique for anterosuperior rotator cuff tears on the primary stability of the subscapularis tendon repair. Study Design: Controlled laboratory study. Methods: A total of 18 fresh-frozen cadaveric shoulders were used in this study. Anterosuperior rotator cuff tears (complete full-thickness tear of the supraspinatus and subscapularis tendons) were created, and supraspinatus repair was performed with a standard suture bridge technique. The subscapularis was repaired with either a (1) single-row or (2) comma sign technique. A high-resolution 3D camera system was used to analyze 3-mm and 5-mm gap formation at the subscapularis tendon-bone interface upon incremental cyclic loading. Moreover, the ultimate failure load of the repair was recorded. A Mann-Whitney test was used to assess significant differences between the 2 groups. Results: The comma sign repair withstood significantly more loading cycles than the single-row repair until 3-mm and 5-mm gap formation occurred (P≤ .047). The ultimate failure load did not reveal any significant differences when the 2 techniques were compared (P = .596). Conclusion: The results of this study show that additional stabilization of the comma sign enhanced the primary stability of subscapularis tendon repair in anterosuperior rotator cuff tears. Although this stabilization did not seem to influence the ultimate failure load, it effectively decreased the micromotion at the tendon-bone interface during cyclic loading. Clinical Relevance: The proposed technique for stabilization of the comma sign has shown superior biomechanical properties in comparison with a single-row repair and might thus improve tendon healing. Further clinical research will be necessary to determine its influence on the functional outcome. Y1 - 2021 U6 - http://dx.doi.org/10.1177/03635465211031506 SN - 1552-3365 SN - 0363-5465 VL - 49 IS - 12 SP - 3212 EP - 3217 PB - Sage CY - London ER - TY - JOUR A1 - Hackl, Michael A1 - Nacov, Julia A1 - Kammerlohr, Sandra A1 - Staat, Manfred A1 - Buess, Eduard A1 - Leschinger, Tim A1 - Müller, Lars P. A1 - Wegmann, Kilian T1 - Intratendinous Strain Variations of the Supraspinatus Tendon Depending on Repair Technique: A Biomechanical Analysis Regarding the Cause of Medial Cuff Failure JF - The American Journal of Sports Medicine Y1 - 2021 U6 - http://dx.doi.org/10.1177/03635465211006138 SN - 1552-3365 SN - 0363-5465 VL - 49 IS - 7 SP - 1847 EP - 1853 PB - Sage CY - London ER - TY - JOUR A1 - Kahmann, Stephanie L. A1 - Rausch, Valentin A1 - Plümer, Jonathan A1 - Müller, Lars P. A1 - Pieper, Martin A1 - Wegmann, Kilian T1 - The automized fracture edge detection and generation of three-dimensional fracture probability heat maps JF - Medical Engineering & Physics N2 - With proven impact of statistical fracture analysis on fracture classifications, it is desirable to minimize the manual work and to maximize repeatability of this approach. We address this with an algorithm that reduces the manual effort to segmentation, fragment identification and reduction. The fracture edge detection and heat map generation are performed automatically. With the same input, the algorithm always delivers the same output. The tool transforms one intact template consecutively onto each fractured specimen by linear least square optimization, detects the fragment edges in the template and then superimposes them to generate a fracture probability heat map. We hypothesized that the algorithm runs faster than the manual evaluation and with low (< 5 mm) deviation. We tested the hypothesis in 10 fractured proximal humeri and found that it performs with good accuracy (2.5 mm ± 2.4 mm averaged Euclidean distance) and speed (23 times faster). When applied to a distal humerus, a tibia plateau, and a scaphoid fracture, the run times were low (1–2 min), and the detected edges correct by visual judgement. In the geometrically complex acetabulum, at a run time of 78 min some outliers were considered acceptable. An automatically generated fracture probability heat map based on 50 proximal humerus fractures matches the areas of high risk of fracture reported in medical literature. Such automation of the fracture analysis method is advantageous and could be extended to reduce the manual effort even further. KW - Fracture classification KW - Shoulder KW - Probability distribution mapping KW - Morphing KW - Imaging Y1 - 2022 SN - 1350-4533 VL - 2022 IS - 110 PB - Elsevier CY - Amsterdam ER -