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Crystal et al: Effect of Medial Opening Wedge and External Rotational Humeral Osteotomies on Medial Elbow Compartment Pressure: An Ex Vivo Study
Veterinary and Comparative Orthopedics and Traumatology 4, 2024

🔍 Key Findings Summary

  • Ex vivo cadaver study using 5 paired canine thoracic limbs
  • Compared medial opening wedge osteotomy (MOWO) and external rotational osteotomy (ERO) of the humerus
  • Measured pressure changes in the medial compartment using thin-film sensors
  • ERO significantly reduced peak pressure and pressure distribution in the medial elbow compartment (p < 0.05)
  • MOWO showed no significant pressure reduction relative to native state
  • Combined MOWO + ERO did not significantly improve over ERO alone
  • Findings support the biomechanical rationale for ERO as a surgical strategy to offload the medial compartment in cases like medial compartment disease (MCD)

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← Articles

Crystal et al: Effect of Medial Opening Wedge and External Rotational Humeral Osteotomies on Medial Elbow Compartment Pressure: An Ex Vivo Study
Veterinary and Comparative Orthopedics and Traumatology 4, 2024

🔍 Key Findings Summary

  • Ex vivo cadaver study using 5 paired canine thoracic limbs
  • Compared medial opening wedge osteotomy (MOWO) and external rotational osteotomy (ERO) of the humerus
  • Measured pressure changes in the medial compartment using thin-film sensors
  • ERO significantly reduced peak pressure and pressure distribution in the medial elbow compartment (p < 0.05)
  • MOWO showed no significant pressure reduction relative to native state
  • Combined MOWO + ERO did not significantly improve over ERO alone
  • Findings support the biomechanical rationale for ERO as a surgical strategy to offload the medial compartment in cases like medial compartment disease (MCD)

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Multiple Choice Questions on this study

In Crystal 2024 et al., on elbow osteotomies, what was the impact of osteotomy orientation (oblique vs. transverse)?

A. Oblique significantly better
B. Transverse significantly better
C. Oblique non-significantly better
D. Orientation had major effects
E. Transverse had higher failure rate

Answer: Oblique non-significantly better

Explanation: Oblique osteotomies reduced load more, but not significantly (adjustment value 2.39, p = 0.85).
In Crystal 2024 et al., on elbow osteotomies, which location of osteotomy provided better reduction of medial elbow pressure?

A. 25% humeral length
B. 40% humeral length
C. 50% humeral length
D. 60% humeral length
E. 75% humeral length

Answer: 75% humeral length

Explanation: More distal osteotomies (75%) significantly reduced medial elbow load more than mid-humeral ones (adjustment value 8.06, p = 0.026).
In Crystal 2024 et al., on elbow osteotomies, which variable most significantly predicted reduced medial elbow load?

A. Orientation of osteotomy
B. Plate screw pattern
C. Osteotomy location
D. Osteotomy angle
E. Osteotomy type

Answer: Osteotomy angle

Explanation: Osteotomy angle had the greatest impact (1.08 unit decrease per 1° angle; p = 0.0002).
In Crystal 2024 et al., on elbow osteotomies, how did opening wedge osteotomies compare to external rotational osteotomies in reducing medial compartment load?

A. More effective
B. Equally effective
C. Rotational osteotomies were superior
D. Only effective when done proximally
E. No effect detected

Answer: More effective

Explanation: Opening wedge osteotomies were more effective at reducing medial load (adjustment value 7.26, p = 0.045).
In Crystal 2024 et al., on elbow osteotomies, which osteotomy angle resulted in the greatest reduction of medial compartment load?

A. 5°
B. 10°
C. 15°
D. 20°
E. 25°

Answer: 20°

Explanation: Increasing osteotomy angle significantly decreased medial compartment load, with 20° yielding the greatest reduction.

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