螺纹k针与皮质螺钉固定治疗O 'Driscoll 2型和3型冠状骨骨折的生物力学比较研究

IF 2 3区医学 Q3 CRITICAL CARE MEDICINE

Injury-International Journal of the Care of the Injured Pub Date : 2025-08-24 DOI:10.1016/j.injury.2025.112717

Cafer Ozgur Hancerli , Ada Ozcecelik , Ergun Bozdag , Abdulhamit Misir

{"title":"螺纹k针与皮质螺钉固定治疗O 'Driscoll 2型和3型冠状骨骨折的生物力学比较研究","authors":"Cafer Ozgur Hancerli , Ada Ozcecelik , Ergun Bozdag , Abdulhamit Misir","doi":"10.1016/j.injury.2025.112717","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Coronoid fractures significantly impact elbow stability, yet limited biomechanical data exists comparing fixation methods for different fracture types. This study aimed to compare the biomechanical performance of threaded K-wire versus cortical screw fixation in O'Driscoll type 2 and 3 coronoid fractures.</div></div><div><h3>Methods</h3><div>Twenty-eight synthetic ulnar bones were divided into four groups (<em>n</em> = 7 each): Type 2 with K-wire fixation, Type 2 with screw fixation, Type 3 with K-wire fixation, and Type 3 with screw fixation. Fractures were created, reduced, and fixed under fluoroscopic guidance. Specimens underwent biomechanical testing using a custom-made apparatus to evaluate load to failure (N), displacement (mm), and stiffness (N/mm). Two-way ANOVA and post-hoc Tukey's tests were used for statistical analysis.</div></div><div><h3>Results</h3><div>Type 2 fractures with screw fixation demonstrated the highest load to failure (1392.59 ± 76.77 N), followed by Type 2 with K-wire fixation (1155.00 ± 200.81 N), Type 3 with K-wire fixation (1093.65 ± 248.68 N), and Type 3 with screw fixation (1058.54 ± 320.46 N), though differences were not statistically significant (<em>p</em> = 0.086). For stiffness, Type 2 fracture fixation fractures exhibited significantly higher values (∼256 N/mm) compared to Type 3 fractures (∼160 N/mm) regardless of fixation method (<em>p</em> = 0.002, Cohen's <em>d</em> = 1.55). The fixation method itself (K-wire vs. screw) did not significantly affect any biomechanical parameter (<em>p</em> > 0.05).</div></div><div><h3>Conclusion</h3><div>O'Driscoll Type 2 fracture fixation provide superior biomechanical stability compared to Type 3 fractures, primarily through enhanced stiffness. While Type 2 screw fixation demonstrated the highest load to failure values, K-wire fixation in Type 2 fractures offered comparable stiffness. These findings suggest that fracture type has a more profound impact on mechanical performance than the choice between K-wire and screw fixation, giving surgeons flexibility in fixation choice for Type 2 fractures while maintaining adequate stability for early rehabilitation.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 11","pages":"Article 112717"},"PeriodicalIF":2.0000,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Threaded K-wire vs cortical screw fixation in O’Driscoll type 2 and 3 coronoid fractures: a comparative biomechanical study\",\"authors\":\"Cafer Ozgur Hancerli , Ada Ozcecelik , Ergun Bozdag , Abdulhamit Misir\",\"doi\":\"10.1016/j.injury.2025.112717\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Coronoid fractures significantly impact elbow stability, yet limited biomechanical data exists comparing fixation methods for different fracture types. This study aimed to compare the biomechanical performance of threaded K-wire versus cortical screw fixation in O'Driscoll type 2 and 3 coronoid fractures.</div></div><div><h3>Methods</h3><div>Twenty-eight synthetic ulnar bones were divided into four groups (<em>n</em> = 7 each): Type 2 with K-wire fixation, Type 2 with screw fixation, Type 3 with K-wire fixation, and Type 3 with screw fixation. Fractures were created, reduced, and fixed under fluoroscopic guidance. Specimens underwent biomechanical testing using a custom-made apparatus to evaluate load to failure (N), displacement (mm), and stiffness (N/mm). Two-way ANOVA and post-hoc Tukey's tests were used for statistical analysis.</div></div><div><h3>Results</h3><div>Type 2 fractures with screw fixation demonstrated the highest load to failure (1392.59 ± 76.77 N), followed by Type 2 with K-wire fixation (1155.00 ± 200.81 N), Type 3 with K-wire fixation (1093.65 ± 248.68 N), and Type 3 with screw fixation (1058.54 ± 320.46 N), though differences were not statistically significant (<em>p</em> = 0.086). For stiffness, Type 2 fracture fixation fractures exhibited significantly higher values (∼256 N/mm) compared to Type 3 fractures (∼160 N/mm) regardless of fixation method (<em>p</em> = 0.002, Cohen's <em>d</em> = 1.55). The fixation method itself (K-wire vs. screw) did not significantly affect any biomechanical parameter (<em>p</em> > 0.05).</div></div><div><h3>Conclusion</h3><div>O'Driscoll Type 2 fracture fixation provide superior biomechanical stability compared to Type 3 fractures, primarily through enhanced stiffness. While Type 2 screw fixation demonstrated the highest load to failure values, K-wire fixation in Type 2 fractures offered comparable stiffness. These findings suggest that fracture type has a more profound impact on mechanical performance than the choice between K-wire and screw fixation, giving surgeons flexibility in fixation choice for Type 2 fractures while maintaining adequate stability for early rehabilitation.</div></div>\",\"PeriodicalId\":54978,\"journal\":{\"name\":\"Injury-International Journal of the Care of the Injured\",\"volume\":\"56 11\",\"pages\":\"Article 112717\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-08-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Injury-International Journal of the Care of the Injured\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0020138325005753\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Injury-International Journal of the Care of the Injured","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0020138325005753","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}

引用次数: 0

摘要

背景冠状面骨折显著影响肘关节的稳定性，但比较不同骨折类型的固定方法的生物力学数据有限。本研究旨在比较螺纹k针与皮质螺钉固定在O'Driscoll 2型和3型冠状骨骨折中的生物力学性能。方法将28块合成尺骨分为4组，每组7块：2型k -丝固定、2型螺钉固定、3型k -丝固定和3型螺钉固定。在透视引导下制造、复位和固定骨折。使用定制的仪器对标本进行生物力学测试，以评估载荷到失效(N)、位移（mm）和刚度（N/mm）。采用双因素方差分析和事后Tukey检验进行统计分析。结果2型骨折骨折失败负荷最大（1392.59±76.77 N），其次为2型（1155.00±200.81 N）、3型（1093.65±248.68 N）和3型（1058.54±320.46 N），但差异无统计学意义（p = 0.086）。对于刚度，无论采用何种固定方法，2型骨折固定骨折的刚度值（~ 256 N/mm）明显高于3型骨折（~ 160 N/mm）（p = 0.002, Cohen’s d = 1.55）。固定方法本身（k针与螺钉）对任何生物力学参数均无显著影响（p > 0.05）。结论与3型骨折相比，o 'Driscoll 2型骨折固定具有更好的生物力学稳定性，主要是通过增强刚度。虽然2型螺钉固定显示出最高的载荷至失效值，但k线固定在2型骨折中的刚度相当。这些研究结果表明，骨折类型对机械性能的影响比选择k针和螺钉固定更深远，这使外科医生在选择2型骨折固定时具有灵活性，同时保持足够的稳定性，以便早期康复。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Threaded K-wire vs cortical screw fixation in O’Driscoll type 2 and 3 coronoid fractures: a comparative biomechanical study

Background

Coronoid fractures significantly impact elbow stability, yet limited biomechanical data exists comparing fixation methods for different fracture types. This study aimed to compare the biomechanical performance of threaded K-wire versus cortical screw fixation in O'Driscoll type 2 and 3 coronoid fractures.

Methods

Twenty-eight synthetic ulnar bones were divided into four groups (n = 7 each): Type 2 with K-wire fixation, Type 2 with screw fixation, Type 3 with K-wire fixation, and Type 3 with screw fixation. Fractures were created, reduced, and fixed under fluoroscopic guidance. Specimens underwent biomechanical testing using a custom-made apparatus to evaluate load to failure (N), displacement (mm), and stiffness (N/mm). Two-way ANOVA and post-hoc Tukey's tests were used for statistical analysis.

Results

Type 2 fractures with screw fixation demonstrated the highest load to failure (1392.59 ± 76.77 N), followed by Type 2 with K-wire fixation (1155.00 ± 200.81 N), Type 3 with K-wire fixation (1093.65 ± 248.68 N), and Type 3 with screw fixation (1058.54 ± 320.46 N), though differences were not statistically significant (p = 0.086). For stiffness, Type 2 fracture fixation fractures exhibited significantly higher values (∼256 N/mm) compared to Type 3 fractures (∼160 N/mm) regardless of fixation method (p = 0.002, Cohen's d = 1.55). The fixation method itself (K-wire vs. screw) did not significantly affect any biomechanical parameter (p > 0.05).

Conclusion

O'Driscoll Type 2 fracture fixation provide superior biomechanical stability compared to Type 3 fractures, primarily through enhanced stiffness. While Type 2 screw fixation demonstrated the highest load to failure values, K-wire fixation in Type 2 fractures offered comparable stiffness. These findings suggest that fracture type has a more profound impact on mechanical performance than the choice between K-wire and screw fixation, giving surgeons flexibility in fixation choice for Type 2 fractures while maintaining adequate stability for early rehabilitation.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Injury-International Journal of the Care of the Injured 医学-急救医学

CiteScore

4.00

自引率

8.00%

发文量

699

审稿时长

96 days

期刊介绍： Injury was founded in 1969 and is an international journal dealing with all aspects of trauma care and accident surgery. Our primary aim is to facilitate the exchange of ideas, techniques and information among all members of the trauma team.