Biomechanical Study of Fixation Methods for Comminuted Phalangeal Fractures

Kwon, Gi-Doo; Yeo, Yong-Bum; Rho, Jeong-Ho; Cho, Bong-Wan; Ahn, Byung-Moon; Bae, Tae-Soo; Kim, Shin-Ki; Mun, Mu-Seong; Han, Kyeong-Jin

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Journal of the Korean Society for Surgery of the Hand 2006;11(4):221-226.
Published online December 1, 2006.

Biomechanical Study of Fixation Methods for Comminuted Phalangeal Fractures

Gi-Doo Kwon, Yong-Bum Yeo, Jeong-Ho Rho, Bong-Wan Cho, Byung-Moon Ahn, Tae-Soo Bae, Shin-Ki Kim, Mu-Seong Mun, Kyeong-Jin Han

수지골 분쇄 골절의 고정 방법에 따른 생역학적 연구

권귀두, 여용범, 노정호, 조봉환, 안병문, 배태수, 김신기, 문무성, 한경진

Correspondence: Kyeong-Jin Han, Tel: 031-219-5220, Fax: 031-219-5229,
Email: kjhan@ajou.ac.kr

Abstract

Purpose
The purpose of this study was to compare the mechanical property of four different methods of fixation of the comminuted fractures of the small tubular bones in compression, bending, torque and bending force.
Materials and Methods: Forty proximal phalangeal and metacarpal bones with similar length (mean 44.0 mm) and width (mean 8.5 mm) were chosen from embalmed cadaver hands. A model with a triangular butterfly fragment in the coronal plane to simulate a comminuted fracture was developed. Four different fixation techniques were (A) Crossed K-wires (B) Lateral plating (C) Intraosseous wiring (D) Composite wiring. The mechanical tests were conducted on a uni-axial biomechanical testing system (Instron 8511, Instron Co., Canton, Massachusette, U.S.A.) and Data Tork (Tohnichi Co., Tokyo, Japan). Statistical analyses were performed using Kruskal-Wallis and Mann-Whitney test and P<0.05 was chosen as the level of significance.

Results
Composite wiring was the most rigid in compression force (p=0.002), lateral plating was the most rigid in bending and torque force (p=0.000, p=0.001), lateral plating and composite wiring were more rigid than the other fixation methods in bending force (p=0.001) but there was no significant difference between lateral plating and composite wiring (p=0.841).

Conclusion
Lateral plating and composite wiring provided more rigidity than the other two fixation methods.

Key Words: Comminuted phalangeal and metacarpal fractures, Fixation methods

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