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Protrusion of Hardware Impairs Forearm Rotation After Olecranon FixationA Report of Two Cases
Felix Matthews, MD1; Otmar Trentz, MD2; Augustinus Ludwig Jacob, MD3; Ron Kikinis, MD1; Jesse B. Jupiter, MD4; Peter Messmer, MD2
1 Surgical Planning Laboratory, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115
2 Division of Trauma Surgery, Department of Surgery, University Hospital of Zurich, Rämistrasse 100, CH-8091 Zurich, Switzerland. E-mail address for P. Messmer: peter.messmer@usz.ch
3 Department of Radiology, University Hospital of Basel, Hebelstrasse 32, CH-4031 Basel, Switzerland
4 Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114
View Disclosures and Other Information
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.
Investigation performed at the Division of Trauma Surgery, University Hospital of Zurich, Zurich, Switzerland, and the Surgical Planning Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2007 Mar 01;89(3):638-642. doi: 10.2106/JBJS.E.01238
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Extract

Tension-band wire fixation is a common surgical technique that is used in the treatment of olecranon fractures and during osteotomies1-3. A number of problems that are specifically related to the use of Kirschner wires have been identified, including wire migration, skin ulceration, and the need for hardware removal4-6. We found only one published article that described diminished forearm rotation following the use of the tension-band technique7.We observed several instances of limitation of forearm rotation following tension-band wire fixation of the olecranon at our medical center (Division of Trauma Surgery, University Hospital of Zurich). Hence, we evaluated computed tomography scans of these patients and developed a computational simulation model with use of three-dimensional computed tomography reconstruction of the elbow. Unlike other authors who studied cadaver elbows3,6-9, we employed a virtual three-dimensional bone model to demonstrate the anatomy of the proximal aspect of the ulna and to simulate Kirschner-wire placement.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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