Stability of fixation of proximal phalanx unicondylar fractures of the hand: a biomechanical cadaver study.
Stability of fixation of proximal phalanx unicondylar fractures of the hand: a biomechanical cadaver study.
- 2013
Available in print through MWHC library: 1999 - 2002, Available online from MWHC library: 1995 - present
CLINICAL RELEVANCE: Fixation of these fractures with any of the methods tested may provide sufficient stability to withstand postoperative therapy when there is no substantial resistance to active motion.Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved. CONCLUSIONS: Biomechanical stability did not differ among the fixation methods for proximal phalanx unicondylar fractures in a flexion-extension active range of motion model. METHODS: We created proximal phalangeal intra-articular unicondylar fractures in 13 fresh-frozen human cadaveric hands. Using a saw through a dorsal approach, we made an osteotomy beginning in the intercondylar notch and extending proximally at a 45degree angle to the radial border of the proximal phalanx. We fixed each of the 4 fingers on each hand with a 1.5-mm headless compression screw, a 1.5-mm lag screw, two 1.1-mm smooth K-wires, or one 1.1-mm smooth K-wire. We rotated the order of constructs randomly for each hand. We simulated active range of motion on a custom-loading device at 0.25 Hz from full finger extension to full flexion for 2,000 cycles and measured displacement by a differential variable reluctance transducer. PURPOSE: To determine the relative stability of various fixation methods for proximal phalanx intra-articular unicondylar fractures during simulated early active motion. RESULTS: We found no significant differences in displacement of the fracture site among the 4 methods of fixation. Movement in the control specimen with no osteotomy fixation was significantly higher than with each of the other fixation methods.
English
0363-5023
*Finger Injuries/su [Surgery]
*Fracture Fixation, Internal/mt [Methods]
*Intra-Articular Fractures/su [Surgery]
Aged
Aged, 80 and over
Biomechanical Phenomena
Humans
Middle Aged
Range of Motion, Articular
Curtis National Hand Center
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Available in print through MWHC library: 1999 - 2002, Available online from MWHC library: 1995 - present
CLINICAL RELEVANCE: Fixation of these fractures with any of the methods tested may provide sufficient stability to withstand postoperative therapy when there is no substantial resistance to active motion.Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved. CONCLUSIONS: Biomechanical stability did not differ among the fixation methods for proximal phalanx unicondylar fractures in a flexion-extension active range of motion model. METHODS: We created proximal phalangeal intra-articular unicondylar fractures in 13 fresh-frozen human cadaveric hands. Using a saw through a dorsal approach, we made an osteotomy beginning in the intercondylar notch and extending proximally at a 45degree angle to the radial border of the proximal phalanx. We fixed each of the 4 fingers on each hand with a 1.5-mm headless compression screw, a 1.5-mm lag screw, two 1.1-mm smooth K-wires, or one 1.1-mm smooth K-wire. We rotated the order of constructs randomly for each hand. We simulated active range of motion on a custom-loading device at 0.25 Hz from full finger extension to full flexion for 2,000 cycles and measured displacement by a differential variable reluctance transducer. PURPOSE: To determine the relative stability of various fixation methods for proximal phalanx intra-articular unicondylar fractures during simulated early active motion. RESULTS: We found no significant differences in displacement of the fracture site among the 4 methods of fixation. Movement in the control specimen with no osteotomy fixation was significantly higher than with each of the other fixation methods.
English
0363-5023
*Finger Injuries/su [Surgery]
*Fracture Fixation, Internal/mt [Methods]
*Intra-Articular Fractures/su [Surgery]
Aged
Aged, 80 and over
Biomechanical Phenomena
Humans
Middle Aged
Range of Motion, Articular
Curtis National Hand Center
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't