Stability of fixation of proximal phalanx unicondylar fractures of the hand: a biomechanical cadaver study.

MedStar author(s):
Citation: Journal of Hand Surgery - American Volume. 38(1):77-81, 2013 Jan.PMID: 23200947Institution: Curtis National Hand CenterForm of publication: Journal ArticleMedline article type(s): Journal Article | Randomized Controlled Trial | Research Support, Non-U.S. Gov'tSubject headings: *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, ArticularYear: 2013Local holdings: Available in print through MWHC library: 1999 - 2002, Available online from MWHC library: 1995 - presentISSN:
  • 0363-5023
Name of journal: The Journal of hand surgeryAbstract: 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.All authors: Higgins JP, Means KR Jr, Parks BG, Sirota MAFiscal year: FY2013Digital Object Identifier: Date added to catalog: 2016-07-15
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 23200947 Available 23200947

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.

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