Does pin configuration matter in modified tension band wiring for transverse patellar fracture? A biomechanical study.

M. Maden, Ali Murat Dulgeroglu, T. Bacaksız, C. Kazımoğlu
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引用次数: 1

Abstract

BACKGROUND Modified tension band wiring has been widely used for the treatment of transverse patellar fractures. The optimal position of a Kirschner wire (K-wire) in modified tension band wiring, however, has not yet been determined. The purpose of the present study was to evaluate biomechanically the effect of K-wire position in a modified tension band wiring technique. METHODS Forty-two polyurethane foam patellae with a midway transverse fracture were assigned to six different fixation groups regarding different pin configurations in tension band wiring. The depth or sagittal position of the K-wire was divided into anterior and posterior. The coronal position of the K-wire was divided into central, medial and lateral. A specially designed set up simulated a knee with 60° flexion. All specimens were tested under axial traction. Loads at 2 mm and 4 mm fracture displacement and at the failure of the construct were recorded. RESULTS At 2 mm fracture displacement, anterolateral (AL) placement of K-wires revealed significantly less durability when compared with five other groups (P < 0.001). At 4 mm fracture displacement, the AL group also revealed inferior biomechanical strength when compared with other groups. Posteromedial (PM) K-wire placement group revealed more durability when compared with the posterolateral (PL) group (P < 0.05). At failure of the osteosynthesis, anteromedial (AM) and anterocentral (AC) groups revealed superior biomechanical strengths (P < 0.05). CONCLUSIONS The coronal and sagittal position of K-wire affects the biomechanical characteristics of modified tension band wiring. Anterolateral placement of K-wires revealed inferior strength to all other constructs in modified anterior tension band wiring.
在改良张力带接线治疗横向髌骨骨折时,针的配置是否重要?生物力学研究。
背景:改良张力带钢丝已广泛应用于髌骨横骨折的治疗。然而,改良张力带布线中克氏丝(k -丝)的最佳位置尚未确定。本研究的目的是评估改良张力带钢丝技术中k针位置的生物力学影响。方法选择42例中段横骨折的聚氨酯泡沫髌骨,根据张力带钢丝针的不同配置,分为6个不同的固定组。k针的深度或矢状位置分为前后。冠状位置分为中央、内侧和外侧。一个特别设计的装置模拟了一个60度弯曲的膝盖。所有标本均在轴向牵引下进行试验。记录了2 mm和4 mm断裂位移和结构破坏时的载荷。结果在2 mm骨折移位时,前外侧放置k针的耐久性明显低于其他5组(P < 0.001)。在4 mm骨折移位时,AL组的生物力学强度也低于其他组。后内侧(PM)放置k线组比后外侧(PL)放置组耐久(P < 0.05)。在骨固定失败时,前内侧组(AM)和前中央组(AC)表现出更强的生物力学强度(P < 0.05)。结论k线的冠状和矢状位置影响改良张力带钢丝的生物力学特性。在改良的前张力带钢丝中,前外侧放置k线的强度低于所有其他构造。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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