Universität zu Köln

Rausch, Valentin, Harbrecht, Andreas, Kahmann, Stephanie L., Fenten, Thomas, Jovanovic, Nebojsa, Hackl, Michael, Mueller, Lars P., Staat, Manfred ORCID: 0000-0003-4363-6570 and Wegmann, Kilian (2020). Osteosynthesis of Phalangeal Fractures: Biomechanical Comparison of Kirschner Wires, Plates, and Compression Screws. J. Hand Surg.-Am. Vol., 45 (10). PHILADELPHIA: W B SAUNDERS CO-ELSEVIER INC. ISSN 1531-6564

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Abstract

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. Conclusion 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. Copyright (C) 2020 by the American Society for Surgery of the Hand. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rausch, Valentin UNSPECIFIED UNSPECIFIED UNSPECIFIED Harbrecht, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Kahmann, Stephanie L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fenten, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Jovanovic, Nebojsa UNSPECIFIED UNSPECIFIED UNSPECIFIED Hackl, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Lars P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Staat, Manfred UNSPECIFIED orcid.org/0000-0003-4363-6570 UNSPECIFIED Wegmann, Kilian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-317091
DOI:	10.1016/j.jhsa.2020.04.010
Journal or Publication Title:	J. Hand Surg.-Am. Vol.
Volume:	45
Number:	10
Date:	2020
Publisher:	W B SAUNDERS CO-ELSEVIER INC
Place of Publication:	PHILADELPHIA
ISSN:	1531-6564
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HAND FRACTURES; METACARPAL FRACTURES; INTERNAL-FIXATION; CLOSED REDUCTION; PROXIMAL PHALANX; COMPLICATIONS; OBLIQUE; MANAGEMENT; SYSTEM; MOTION Multiple languages Orthopedics; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31709