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

2021 ◽  
Vol 32 (1) ◽  
pp. 75-84
Author(s):  
Serhat Durusoy
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Kirschner Wire ◽  
Fracture Line ◽  
Kirschner Wires ◽  
Element Analysis ◽  
Kirschner Wire Fixation ◽  
Supracondylar Humerus Fractures ◽  
Wire Fixation ◽  
Humerus Fractures

scholarly journals A study on management of paediatric supracondylar humerus fractures with lateral percutaneous Kirschner wire fixation

2019 ◽  
Vol 5 (5) ◽  
pp. 911
Author(s):  
Wazir Fahad Jan ◽  
Umer Mushtaq Khan ◽  
Haamid Rafiq Bhat ◽  
Sumaya Zeerak
Keyword(s):  
Kirschner Wire ◽  
Functional Results ◽  
Supracondylar Fractures ◽  
College Hospital ◽  
Medical College ◽  
Kirschner Wire Fixation ◽  
Supracondylar Humerus Fractures ◽  
Wire Fixation ◽  
Cosmetic Outcomes ◽  
Humerus Fractures

<p class="abstract"><strong>Background:</strong> Supracondylar fracture of the humerus in children is a common injury encountered in orthopaedic practice. Undisplaced fractures can be managed conservatively, however displaced fractures need proper reduction and adequate fixation for attainment of optimal functional and cosmetic outcomes. The purpose of this study was to evaluate the effectiveness of lateral percutaneous Kirschner (K) wire fixation in the management of displaced supracondylar fractures in relation to achievement of union and functional results.</p><p class="abstract"><strong>Methods:</strong> This was a prospective observational study conducted on 70 patients of either sex with an average age of 5.98 years, presenting to the Orthopaedic Department of S.H.K.M. Government Medical College Hospital, Nalhar, Nuh, Haryana between February 2016 and February 2018, with displaced supracondylar fractures of humerus. All the patients were managed by closed reduction and percutaneous lateral K wire fixation. The patients were followed up for a period of 1 year. The patients were analyzed for union and functional results.<strong></strong></p><p class="abstract"><strong>Results:</strong> All the fractures united with an average time of union of 3.8 weeks. Functional results were assessed using Flynn’s criteria, which were excellent in 58 (82.86%), good in 7 (10%), fair in 3 (4.28%) and poor in 2 (2.86%) patients.</p><p class="abstract"><strong>Conclusions:</strong> Thus results of our study demonstrate that the lateral percutaneous K wire fixation is a safe and effective method of treatment of displaced paediatric supracondylar humerus fractures.</p>

scholarly journals UK DRAFFT: a randomised controlled trial of percutaneous fixation with Kirschner wires versus volar locking-plate fixation in the treatment of adult patients with a dorsally displaced fracture of the distal radius

2015 ◽  
Vol 19 (17) ◽  
pp. 1-124 ◽  
Author(s):  
Matthew L Costa ◽  
Juul Achten ◽  
Caroline Plant ◽  
Nick R Parsons ◽  
Amar Rangan ◽  
...  
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Plate Fixation ◽  
Kirschner Wire ◽  
Health Technology ◽  
Kirschner Wires ◽  
Locking Plate Fixation ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Displaced Fracture

BackgroundIn high-income countries, 6% of all women will have sustained a fracture of the wrist (distal radius) by the age of 80 years and 9% by the age of 90 years. Advances in orthopaedic surgery have improved the outcome for patients: many such fractures can be treated in a plaster cast alone, but others require surgical fixation to hold the bone in place while they heal. The existing evidence suggests that modern locking-plate fixation provides improved functional outcomes, but costs more than traditional wire fixation.MethodsIn this multicentre trial, we randomly assigned 461 adult patients having surgery for an acute dorsally displaced fracture of the distal radius to either percutaneous Kirschner-wire fixation or locking-plate fixation. The primary outcome measure was the Patient-Rated Wrist Evaluation©(PRWE) questionnaire at 12 months after the fracture. In this surgical trial, neither the patients nor the surgeons could be blind to the intervention. We also collected information on complications and combined costs and quality-adjusted life-years (QALYs) to assess cost-effectiveness.ResultsThe baseline characteristics of the two groups were well balanced and over 90% of patients completed follow-up. Both groups of patients recovered wrist function by 12 months. There was no clinically relevant difference in the PRWE questionnaire score at 3 months, 6 months or 12 months [difference at 12 months: –1.3; 95% confidence interval (CI) –4.5 to 1.8;p = 0.398]. There was no difference in the number of complications in each group and small differences in QALY gains (0.008; 95% CI –0.001 to 0.018); Kirschner-wire fixation represents a cost-saving intervention (–£727; 95% CI –£588 to –£865), particularly in younger patients.ConclusionsContrary to the existing literature, and against the increasing use of locking-plate fixation, this trial shows that there is no difference between Kirschner wires and volar locking plates for patients with dorsally displaced fractures of the distal radius. A Kirschner-wire fixation is less expensive and quicker to perform.Trial registrationCurrent Controlled Trials ISRCTN31379280.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 19, No. 17. See the NIHR Journals Library website for further project information.

Arthrodesis of the Interphalangeal Joint of the Hallux

2001 ◽  
Vol 91 (8) ◽  
pp. 427-434 ◽  
Author(s):  
Gerard V. Yu ◽  
Frank E. Vargo ◽  
Joel W. Brook
Keyword(s):  
Simple Technique ◽  
Functional Unit ◽  
Screw Fixation ◽  
Kirschner Wire ◽  
Interphalangeal Joint ◽  
Kirschner Wires ◽  
Effective Technique ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Common Problems

The authors present a simple and effective technique to achieve arthrodesis of the hallucal interphalangeal joint. Stabilization is achieved by external fixation with crossing Kirschner wires joined together to create a single functional unit, a technique that avoids common problems often associated with Kirschner-wire fixation. The authors propose that this simple technique be considered for patients in whom it has been determined that screw fixation should not be used to obtain fusion of the interphalangeal joint. (J Am Podiatr Med Assoc 91(8): 427-434, 2001)

scholarly journals Mind the gap between the fracture line and the length of the working area: a 2-D finite element analysis using an extramedullary fixation model

2018 ◽  
Vol 53 (1) ◽  
pp. 88-93
Author(s):  
Vincenzo Giordano ◽  
Alexandre Leme Godoy dos Santos ◽  
William Dias Belangero ◽  
Robinson Esteves Santos Pires ◽  
Pedro José Labronici ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Fracture Line ◽  
Element Analysis ◽  
Extramedullary Fixation

Outcome of Proximal Chevron Osteotomy for Hallux Valgus With and Without Transverse Kirschner Wire Fixation

2008 ◽  
Vol 29 (11) ◽  
pp. 1101-1106 ◽  
Author(s):  
Keun-Bae Lee ◽  
Chang-Young Seo ◽  
Chang-Ich Hur ◽  
Eun-Sun Moon ◽  
Jae-Jun Lee
Keyword(s):  
Hallux Valgus ◽  
Kirschner Wire ◽  
Kirschner Wires ◽  
Fixation Group ◽  
Chevron Osteotomy ◽  
Kirschner Wire Fixation ◽  
Group I ◽  
Wire Fixation ◽  
Group Ii ◽  
Severe Hallux Valgus

Background: Proximal chevron osteotomy (PCO) for hallux valgus is inherently more stable than the other forms of proximal metatarsal osteotomy, but complications, such as, delayed union, nonunion, and malunion can occur. In this study, we have compared results of two axial Kirschner wire fixation with or without transverse Kirschner wires in PCO for moderate to severe hallux valgus deformities. Methods: A prospective study was conducted on 65 patients (85 feet) that underwent PCO and a distal soft tissue procedure for moderate to severe hallux valgus. Patients were divided into two groups, two axial Kirschner wire fixation (Group I) and two axial and supplementary transverse Kirschner wire fixation (Group II). Group I comprised 41 feet of 32 patients and Group II 44 feet of 33 patients. Results: Average AOFAS scores were 52.8 points in group I and 49.6 points in group II preoperatively, and 92.8 and 89.6 points, respectively, at last followup. Patients were very satisfied or satisfied in 92.7% in Group I and 93.2% in Group II. Average hallux valgus angles in Groups I and II changed from 34.9 degrees and 37.2 degrees preoperatively to 12.3 degrees and 13.9 degrees postoperatively, and intermetatarsal angles in Groups I and II changed from an average of 17.9 degrees and 17.2 degrees preoperatively to 10.3 degrees and 10.4 degrees postoperatively. No significant inter-group differences were found. Conclusion: Supplementary transverse Kirschner wire fixation is not recommended for proximal metatarsal chevron osteotomy since two axial Kirschner wires provided sufficient stability. Level of Evidence: I, Prospective Radomized Study

scholarly journals The most stable pinning configurations in transverse supracondylar humerus fracture fixation in children: A novel three-dimensional finite element analysis of a pediatric bone model

2020 ◽  
Author(s):  
Allieu Kamara ◽  
Xianglu Ji ◽  
Chuang Liu ◽  
Tianjing Liu ◽  
Enbo Wang
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Preoperative Evaluation ◽  
Humerus Fracture ◽  
Supracondylar Humerus Fracture ◽  
Element Analysis ◽  
Bone Model ◽  
Fractures In Children ◽  
Supracondylar Humerus Fractures ◽  
Flexion Extension

Abstract Background : This study aimed at finding out the effect of exit height of pins, pin trajectory and pin number on the stability of crossed and lateral pinning configurations used in the fixation of extension-type supracondylar humerus fracture (SHF) in children, through finite element analysis of a novel pediatric humerus bone model. Method : Distal humerus model consisting of the ossific nucleus of the capitellum (ONC) and distal cartilage of a 6-year-old boy was developed computationally. Various crossed and lateral pinning fixation models with either two or three pins were simulated on an extension-type, transverse SHF and tested in six loading directions. Results : Two-crossed pins and 2-lateral pins were respectively more stable in rotation and compression loadings, while 3-crossed pins were the most stable in all loading directions. The crossed pins exiting at the upper border of the distal metaphyseal-diaphyseal junction (MDJ) had the best stiffness among the 2-crossed pins, while the lateral pins with a mid-ONC distal pin provided the best stiffness among the 2-lateral pins. A third pin however, going through the olecranon fossa led to improved stability of the 2-lateral pins in flexion, extension, internal and external rotations. Conclusion : In the fixation of extension-type, transverse supracondylar humerus fractures, 2-crossed pins are only superior to 2-divergent lateral pins in rotational loadings. Two-crossed pins exiting at the upper border of the MDJ provides the best stability, whereas 2-lateral pins with a distal pin going through the middle third of the ONC provides the best stability against compression forces for these fractures. Three-crossed pins however offer the best stability against both compression and rotation forces.This study offers important clues in the preoperative evaluation and management of extension-type supracondylar fractures in children.

scholarly journals The most stable pinning configurations in transverse supracondylar humerus fracture fixation in children: A novel three-dimensional finite element analysis of a pediatric bone model

2020 ◽  
Author(s):  
Allieu Kamara ◽  
Xianglu Ji ◽  
Chuang Liu ◽  
Tianjing Liu ◽  
Enbo Wang
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Three Dimensional ◽  
Humerus Fracture ◽  
Supracondylar Humerus Fracture ◽  
Element Analysis ◽  
Bone Model ◽  
Fractures In Children ◽  
Supracondylar Humerus Fractures ◽  
Flexion Extension

Abstract Background: This study aimed at finding out the effect of exit height of pins, pin trajectory and pin number on the stability of cross and lateral pinning configurations used in the fixation of extension-type supracondylar humerus fracture (SHF) in children, through finite element analysis of a novel pediatric humerus bone model. Methods: Distal humerus model consisting of the ossific nucleus of the capitellum (ONC) and distal cartilage of a 6-year-old boy was developed via three-dimensional finite modeling. Various cross and lateral pinning fixation models with either two or three pins were simulated on an extension-type, transverse SHF and tested in six loading directions. Results: Two-cross pins and 2-lateral pins were respectively more stable in rotation and compression loadings, while 3-cross pins were the most stable in all loading directions. The cross pins exiting at the upper border of the distal metaphyseal-diaphyseal junction (MDJ) had the best stiffness among the 2-cross pins, while the lateral pins with a mid-ONC distal pin provided the best stiffness among the 2-lateral pins. A third pin however, going through the olecranon fossa led to improved stability of the 2-lateral pins in flexion, extension, internal and external rotations. Conclusion: In the fixation of extension-type, transverse supracondylar humerus fractures, 2-cross pins are only superior to 2-divergent lateral pins in rotational loadings. Two-cross pins exiting at the upper border of the MDJ provides the best stability, whereas 2-lateral pins with a distal pin going through the middle third of the ONC provides the best stability against compression forces for these fractures. Three-cross pins however offer the best stability against both compression and rotation forces. This study offers important clues in the preoperative evaluation and management of extension-type supracondylar fractures in children.

Sign in / Sign up

Export Citation Format

Share Document