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Dmour A, Toma ȘL, Cazac AM, Tirnovanu SD, Dima N, Dmour BA, Popescu DC, Alexa O. Comparative Biomechanical Analysis of Kirschner Wire Fixation in Dorsally Displaced Distal Radius Fractures. Life (Basel) 2024; 14:1684. [PMID: 39768391 PMCID: PMC11677149 DOI: 10.3390/life14121684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2024] [Accepted: 12/17/2024] [Indexed: 01/11/2025] Open
Abstract
OBJECTIVE This study aims to evaluate and compare the biomechanical performance of two Kirschner (K) wire configurations-the intra-focal and interfragmentary techniques-for the fixation of dorsally displaced distal radius fractures. The study also assesses the impact of K-wire diameter (1.6 mm vs. 2.0 mm) on mechanical stability. METHODS Sixty fresh turkey tarsometatarsus bones were selected and divided into four groups based on the K-wire configuration and diameter used. Fractures were created at standardized locations, and each bone was stabilized using either the intra-focal also known as modified Kapandji (Ka) or interfragmentary technique. Mechanical testing, including axial compression and flexion tests, was performed to assess the biomechanical stability of each configuration. RESULTS The interfragmentary configuration consistently demonstrated superior biomechanical performance compared to the intra-focal technique. Specifically, the use of 2.0 mm K-wires resulted in significantly higher axial stiffness (13.28 MPa) and load at break (3070 N) compared to the 1.5 mm wires. Confidence intervals further supported the robustness of these findings. The interfragmentary technique, especially with thicker K-wires, provided greater load-bearing capacity and stiffness. CONCLUSION The interfragmentary technique with 2.0 mm K-wires offers superior mechanical stability compared to the intra-focal technique, making it the preferred choice for stabilizing comminuted extra-articular distal radius fractures. These findings suggest that adopting this technique may reduce the risk of postoperative complications such as fracture displacement or malunion. Further research involving osteoporotic bone models and clinical trials is recommended to validate these findings in real-world settings.
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Affiliation(s)
- Awad Dmour
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.D.); (S.D.T.); (O.A.)
| | - Ștefan-Lucian Toma
- Materials Science Department, Materials Science and Engineering Faculty, Gheorghe Asachi Technical University of Iasi, 700050 Iasi, Romania;
| | - Alin-Marian Cazac
- Materials Science Department, Materials Science and Engineering Faculty, Gheorghe Asachi Technical University of Iasi, 700050 Iasi, Romania;
| | - Stefan Dragos Tirnovanu
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.D.); (S.D.T.); (O.A.)
- Department of Orthopaedics and Traumatology, “Sf. Spiridon” Emergency Universitary Hospital, 700115 Iasi, Romania
| | - Nicoleta Dima
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (N.D.); (B.-A.D.)
- Department of III Internal Medicine Clinic, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania
| | - Bianca-Ana Dmour
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (N.D.); (B.-A.D.)
- Department of III Internal Medicine Clinic, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania
| | - Dragos Cristian Popescu
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.D.); (S.D.T.); (O.A.)
- Department of Orthopaedics and Traumatology, “Sf. Spiridon” Emergency Universitary Hospital, 700115 Iasi, Romania
| | - Ovidiu Alexa
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (A.D.); (S.D.T.); (O.A.)
- Department of Orthopaedics and Traumatology, “Sf. Spiridon” Emergency Universitary Hospital, 700115 Iasi, Romania
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Meng H, Xu B, Xu Y, Niu H, Liu N, Sun D. Treatment of distal radius fractures using a cemented K-wire frame. BMC Musculoskelet Disord 2022; 23:591. [PMID: 35725465 PMCID: PMC9208138 DOI: 10.1186/s12891-022-05550-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 06/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This retrospective study included an alternative treatment for types A2, A3, and B1 distal radius fractures using percutaneous fixation with a cemented K-wire frame. METHODS From January 2017 to January 2020, 78 patients with distal radius fractures were treated with percutaneous internal fixation using a cemented K-wire frame. There were 47 male patients and 31 female patients. The fractures were classified into types A2 (n = 10), A3 (n = 46), and B1 (n = 22). X-rays were taken immediately after surgery and after the bone had healed. Wrist function was assessed using the Mayo Wrist Score (90-100, excellent; 80-90, good; 60-80, satisfactory; < 60, poor). Patient satisfaction was assessed using the 10-cm visual analog scale. RESULTS Neither fixation failure nor K-wire migration was found (P > 0.05). Osteomyelitis was not observed in this series. All patients achieved bone healing after a mean of 4.5 weeks (range, 4 to 8 weeks). Follow-up lasted a mean of 27 months (range, 24 to 33 months). The mean score of wrist function was 97 (range, 91 to 100). Among them, 66 results were excellent and 12 results were good. The mean patient satisfaction was 10 cm (range, 8 to 10 cm). CONCLUSIONS Percutaneous fixation with cemented K-wire frame is a safe and preferred choice for the treatment of types A2, A3, and B1 distal radius fractures. The frame provides support to prevent wire migration. The fixation technique is a minimally invasive procedure that is easy to perform. LEVEL OF EVIDENCE Therapeutic study, Level IVa.
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Affiliation(s)
- Hongyu Meng
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei, China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050000, Hebei, China.,Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050000, Hebei, China
| | - Bin Xu
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei, China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050000, Hebei, China.,Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050000, Hebei, China
| | - Yi Xu
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei, China
| | - Haiyun Niu
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei, China
| | - Ning Liu
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei, China. .,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050000, Hebei, China. .,Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050000, Hebei, China. .,Department of Hand Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China.
| | - Donglei Sun
- Central Laboratory, Second Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei, China.
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