Medartis | Olecranon System 2.8

Designed to perform.

The Medartis Olecranon System 2.8 offers a range of plates with innovative fixation concepts that may help reduce soft tissue irritation and therefore reduce the rates of hardware removal surgeries. ^[1]

^[1] A. Ellwein, K. Argiropoulos, R.-O. DeyHazra, M.-F. Pastor, T. Smith, H. Lill “Clinical evaluation of double-plate osteosynthesis for olecranonfractures: A retrospective case-control study” Orthopaedics & Traumatology: Surgery & Research, 2019, 105 (8); 1601-1606

Fixation Options

The low profile 2.8 TriLock Olecranon Double Plates are designed to fix complex olecranon fractures without interfragmentary support. Their innovative lateral positioning allows for muscular soft tissue coverage and an increased amount of screws to hold small proximal fragments. ^[2]

The 2.8 TriLock olecranon tension plate was developed as a replacement of the classic tension band wiring. The low-profile plate is very thin entailing limited hardware prominence ^[3] and can withstand tensile forces. It is indicated for fractures and osteotomies of the proximal ulna with interfragmentary support.

For complex olecranon fractures, including Monteggia fractures, Medartis includes in the portfolio the 2.8 TriLock Dorsal Olecranon Plates, featuring an excellent anatomical fit and dedicated pre-angled screw holes to enable specific screw trajectories aiming into the coronoid. Plates are available in various lengths with three proximal end configurations. Medartis provides various olecranon fracture treatment options offering versatile solutions tailored to fracture patterns and surgeon preferences.

^[2] F.C. Wagner, M. Jaeger, C. Friebis, D. Maier, C. Ophoven, T. Yilmaz, N.P. Südkamp, K. Reising, “Low-profile double plating of unstable osteoporotic olecranon fractures: a biomechanical comparative study”, J Shoulder Elbow Surg, 2021, 30(7); PP1519-1526

^[3] D. Gruszka, C. Arand, T. Nowak, S.O. Dietz, D. Wagner, P. Rommens, «Olecranon tension plating or olecranon tension band wiring? A comparative biomechanical study», International Orthopaedics (SICOT), 2015, 39:955-960

Curved Double Plates

Straight Double Plates

Tension Plate

Dorsal Olecranon Plates

For further information on the implants. Surgical Technique

TriLock Olecranon Curved Double Plates 2.8

Web GL Curved Plates

Highlights

Low plate profile and high rotational stability due to biomechanically favourable posterolateral and posteromedial plate position
Plates can be covered with soft tissue (anconeus muscle and flexor carpi ulnaris muscle), thereby reducing the occurrence of wound healing problems and the likelihood of hardware removal ^[1,2]
High number of screw options enables stable fixation particularly of small proximal fragments ^[2]
High primary stability due to screw position orthogonally to the direction of the pulling force of the triceps brachii muscle ^[2]
Easy bending to adapt to the individual anatomy of the patient

TriLock

Multidirectional locking, screws can pivot freely by ± 15° in all directions

HexaDrive

Simplified screw pick-up due to self-holding technology

Oblong hole

Oblong hole for minor plate adjustments

Rounded edges

Rounded edges for soft tissue protection

Bendable

Plates can be bent with specific plate bending pliers

For further information on the implants. Surgical Technique

TriLock Olecranon Straight Double Plates 2.8

Web GL Olecranon Straight Plates

Highlights

Distal plate position spares the triceps tendon insertion
Low plate profile and high rotational stability due to biomechanically favourable posterolateral and posteromedial plate position
Plates can be covered with soft tissue (anconeus muscle and flexor carpi ulnaris muscle), thereby reducing the occurrence of wound healing problems and the likelihood of hardware removal ^[1,2]

TriLock

Multidirectional locking, screws can pivot freely by ± 15° in all directions

HexaDrive

Simplified screw pick-up due to self-holding technology

Rounded edges

Rounded edges for soft tissue protection

Bendable

Plates can be bent with specific plate bending pliers

Oblong hole

Oblong hole for minor plate adjustments

For further information on the implants. Surgical Technique

TriLock Olecranon Tension Plate 2.8

Web GL Tension Plate 2.8

Highlights

Developed as a replacement of the classic tension band wiring
The low-profile plate is very thin entailing limited hardware prominence ^[3] and can withstand tensile forces
Two cross-fracture lag screws provide primary compression and fixation ^[3]
Uniform and controlled compression of the fracture with lag screws allows for mobilization as early as possible ^[3]
Solid anchoring of the tension relief even in osteoporotic bone reduces the risk of fracture dislocation ^[3]

TriLock

Multidirectional locking, screws can pivot freely by ± 15° in all directions

HexaDrive

Simplified screw pick-up due to self-holding technology

Rounded edges

Rounded edges for soft tissue protection

Bendable

Plates can be bent with specific plate bending pliers

Surgical Technique

TriLock Dorsal Olecranon Plates 2.8

Three proximal plate ends, left and right versions, and various lengths: 22 plates to allow for individual plate selection according to fracture pattern and surgeon preference
Excellent anatomical fit*
Fixation of coronoid fragments by placing screws with specific trajectories into the coronoid

* Feedback from 65 surgeries: 98.5% found anatomical fit good or very good. Bending was needed in 5/65 surgeries

TriLock

Multidirectional locking, screws can pivot freely by ± 15° in all directions

TriLock^PLUS

TriLockPlus screw holes offer the advantage of locking and compression in one step

HexaDrive

Simplified screw pick-up due to self-holding technology

Bendable

Plates can be bent with specific plate bending pliers

Dimensions

Dimensions of the plate

Oblong hole

Oblong hole for minor plate adjustments

Screws

Locking
2.8 TriLock Screws,
HexaDrive 7

Non-locking
2.8 Cortical Screws,
HexaDrive 7

Lag Screws
2.8 Lag Screws,
HexaDrive 7

^Only^{for 2.8 TriLock Tension Plate}

The science behind.

Fractures of the proximal ulna: current concepts in surgical management. Siebenlist, S., Buchholz, A., Braun, K. F. 2019 EFORT Open Reviews

Abstract

Fractures of the proximal ulna range from simple olecranon fractures to complex Monteggia fractures or Monteggia-like lesions involving damage to stabilizing key structures of the elbow (i.e. coronoid process, radial head, collateral ligament complex).
In complex fracture patterns a computerized tomography scan is essential to properly assess the injury severity.
Exact preoperative planning for the surgical approach is vital to adequately address all fracture parts (base coronoid fragments first).
The management of olecranon fractures primarily comprises tension-band wiring in simple fractures as a valid treatment option, but modern plate techniques, especially in comminuted or osteoporotic fracture types, can reduce implant failure and potential implant-related soft tissue irritation.
For Monteggia injuries, the accurate anatomical restoration of ulnar alignment and dimensions is crucial to adjust the radiocapitellar joint.
Caution is advised if the anteromedial facet (anatomical insertion of the medial collateral ligament) of the coronoid process is affected, to avoid posteromedial instability.
Radial head reconstruction or replacement is essential in Monteggia-like lesions to restore normal elbow function.
The postoperative rehabilitation programme should involve active elbow motion exercises without limitations as early as possible following surgery to avoid joint stiffness.