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Biomechanical analysis between Orthofix® external fixator and different K-wire configurations for pediatric supracondylar humerus fractures.

Abstract：

BACKGROUND:Closed reduction and percutaneous fixation are considered as the optional treatments for displaced supracondylar humerus fractures. However, there was no published report about the biomechanical analysis in Orthofix® external fixator. In this study, we developed a model of supracondylar humerus fractures and compared the biomechanical analysis of external fixator and different K-wires configurations in order to evaluate the stability of external fixator in supracondylar humerus fractures. METHODS:We developed an anatomic humerus model by third-generation synthetic composite, and 60 synthetic humeris were osteotomized to simulate the humeral transverse supracondylar fracture. Those fractures were reduced and fixed by external fixator or K-wires, and then biomechanical analysis was performed in extension, varus, valgus, and internal and external rotation loading. A paired-sample t test was used to evaluate the distance at the fracture site between the external fixator and K-wire configurations. RESULTS:During all direction loading, there was a significant statistical difference between external fixator and K-wires (P < 0.001 for all pairwise comparisons). In extension and internal rotation loading, the external fixator and three crossed K-wires had no comparable stiffness values (P = 0.572; P = 0.795), and both were significantly greater than two crossed and lateral K-wires (P < 0.05). In external rotation loading, there was no significance between the external fixator and K-wire configurations except two lateral K-wires (P > 0.05). In valgus loading, the stability of the external fixator was less than that of three crossed K-wires (P = 0.001) but was not significantly different with those of two crossed or three lateral K-wires (P = 0.126; P = 0.564). In varus loading, the stability of the external fixator was larger than those of two and three lateral K-wires (P = 0.000; P = 007). CONCLUSIONS:External fixator could provide enough stability for pediatric supracondylar humerus fractures without the injury of the ulnar nerve. Besides, it could enhance the rotational stiffness of the construct in rotation loading to avoid the complication of cubitus varus.

journal_name

J Orthop Surg Res

journal_title

Journal of orthopaedic surgery and research

authors

Li WC,Meng QX,Xu RJ,Cai G,Chen H,Li HJ

doi

10.1186/s13018-018-0893-z

subject

Has Abstract

pub_date

2018-07-28 00:00:00

pages

188

issue

issn

1749-799X

pii

10.1186/s13018-018-0893-z

journal_volume

pub_type

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Biomechanical analysis between Orthofix® external fixator and different K-wire configurations for pediatric supracondylar humerus fractures.