Journals / Joint diseases and related surgery / 2021 / Cilt: 32 - Sayı: 1

The effect of the angle between fracture line andKirschner wires on stability in supracondylar humerus fractures treated with Kirschner wire fixation: A finite element analysis

Pages
75–84
Publication Date
2022-10-19
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Despite having generally lower fracture displacement, the increased α and β angles led to variable changes in the stress on K-wires against flexion and extension forces.Conclusion: In supracondylar humerus fractures, increasing the insertion angle of both medial and lateral K-wires augments stabilization and reduces displacement, particularly against rotational deforming forces.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objectives: This study aims to investigate the effects of the angles created by the Kirschner wires (K-wires), which are applied in the percutaneous fixation of supracondylar humerus fractures with cross K-wire, with the fracture line on fracture stabilization.Patientsandmethods:The study was conducted on distal humerus fracture models.
📊
Key Findings & Data:A combination of various angles (30°, 45°, and 60°) was used in each model, where no two models had the same combination of α and β, resulting in nine different wire configurations.
💡
Conclusion & Impact:Despite having generally lower fracture displacement, the increased α and β angles led to variable changes in the stress on K-wires against flexion and extension forces.Conclusion: In supracondylar humerus fractures, increasing the insertion angle of both medial and lateral K-wires augments stabilization and reduces displacement, particularly against rotational deforming forces.
🔬Design:Modeling & Simulation
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objectives: This study aims to investigate the effects of the angles created by the Kirschner wires (K-wires), which are applied in the percutaneous fixation of supracondylar humerus fractures with cross K-wire, with the fracture line on fracture stabilization.Patientsandmethods:The study was conducted on distal humerus fracture models. Medial and lateral K-wires were placed in the fracture models. The angle between the fracture line and the K-wire inserted from medial was represented by alpha (α), while the angle between the fracture line and the K-wires inserted from lateral was represented by beta (β). A combination of various angles (30°, 45°, and 60°) was used in each model, where no two models had the same combination of α and β, resulting in nine different wire configurations. The simulation program was used to simulate the effects of forces, which were applied on rotation, flexion and extension directions, on these models. We measured and compared the stress on the wires and the displacement of fractures under different force configurations.Results: When the force was applied in the counterclockwise direction, the stresses were 58 megapascal (MPa) on medial K-wire, 24 MPa on lower lateral K-wire, and 45 MPa on upper lateral K-wire in (45°, 45°) wire configuration. When the force was applied in the clockwise direction, the stresses were 57 MPa on medial K-wire, 23 MPa on lower lateral K-wire, and 45 MPa on upper lateral K-wire in (45°, 45°) wire configuration. In all models, the increased α and β angles were translated into the decreased stress on K-wires at the fracture level and decreased displacement under rotational deforming forces. Despite having generally lower fracture displacement, the increased α and β angles led to variable changes in the stress on K-wires against flexion and extension forces.Conclusion: In supracondylar humerus fractures, increasing the insertion angle of both medial and lateral K-wires augments stabilization and reduces displacement, particularly against rotational deforming forces.

🔖

Cite This Article

SEVİNÇ, H. F., DURUSOY, S., ÖNER, K., ÖZER, A. (2022). The effect of the angle between fracture line andKirschner wires on stability in supracondylar humerus fractures treated with Kirschner wire fixation: A finite element analysis. Joint diseases and related surgery, Cilt: 32 - Sayı: 1, 75–84. https://ajindex.com/articles/559245

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (12)

  1. Ralles S, Murphy M, Bednar MS, Fishman FG. Surgical Trends in the Treatment of Supracondylar Humerus Fractures in Early Career Practice: An American Board of Orthopaedic Surgery (ABOS) Part-II Database Study. J Pediatr Orthop 2020;40:223-7
  2. Holt JB, Glass NA, Shah AS. Understanding the epidemiology of pediatric supracondylar humeral fractures in the united states: identifying opportunities for intervention. J Pediatr Orthop 2018;38:e245-e251
  3. Ladenhauf HN, Schaffert M, Bauer J. The displaced supracondylar humerus fracture: indications for surgery and surgical options: a 2014 update. Curr Opin Pediatr 2014;26:64-9
  4. Barr LV. Paediatric supracondylar humeral fractures: epidemiology, mechanisms and incidence during school holidays. J Child Orthop 2014;8:167-70
  5. Edmonds EW, Roocroft JH, Mubarak SJ. Treatment of displaced pediatric supracondylar humerus fracture patterns requiring medial fixation: a reliable and safer cross-pinning technique. J Pediatr Orthop 2012;32:346-51
  6. Liu C, Kamara A, Liu T, Yan Y, Wang E. Mechanical stability study of three techniques used in the fixation of transverse and oblique metaphyseal-diaphyseal junction fractures of the distal humerus in children: a finite element analysis. J Orthop Surg Res 2020;15:34
  7. Mills NJ. Finite element modelling of foam deformation [Internet]. In: Mills NJBT-PFH, editor. Chapter 6. Oxford: Butterworth-Heinemann; 2007. p. 115-45. Available at: http://www.sciencedirect.com/science/article/pii/ B9780750680691500076 [Accessed: October 12, 2007] 8. Atik OŞ. Is there something new and interesting in my article? Eklem Hastalik Cerrahisi 2019;30:69
  8. Lamdan R, Liebergall M, Gefen A, Symanovsky N, Peleg E. Pediatric supracondylar humerus fractures: effect of boneimplant interface conditions on fracture stability. J Child Orthop 2013;7:565-9
  9. Ling M, Zhan S, Jiang D, Hu H, Zhang C. Where should Kirschner wires be placed when fixing patella fracture with modified tension-band wiring? A finite element analysis. J Orthop Surg Res 2019;14:14
  10. Rupp M, Schäfer C, Heiss C, Alt V. Pinning of supracondylar fractures in children - Strategies to avoid complications. Injury 2019;50 Suppl 1:S2-S9
  11. Gottschalk HP, Sagoo D, Glaser D, Doan J, Edmonds EW, Schlechter J. Biomechanical analysis of pin placement for pediatric supracondylar humerus fractures: does starting point, pin size, and number matter? J Pediatr Orthop 2012;32:445-51
  12. Salonen A, Pajulo O, Lahdes-Vasama T, Välipakka J, Mattil