Reconstruction of a Mason type-III fracture of the radial head using four different fixation techniques. An experimental study
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Reconstruction of a Mason type-III fracture of the radial head using four different fixation techniques. An experimental study. / Koslowsky, T C; Mader, K; Dargel, J; Koebke, J; Hellmich, M; Pennig, D.
In: J BONE JOINT SURG BR, Vol. 89, No. 11, 11.2007, p. 1545-50.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Reconstruction of a Mason type-III fracture of the radial head using four different fixation techniques. An experimental study
AU - Koslowsky, T C
AU - Mader, K
AU - Dargel, J
AU - Koebke, J
AU - Hellmich, M
AU - Pennig, D
PY - 2007/11
Y1 - 2007/11
N2 - We have evaluated four different fixation techniques for the reconstruction of a standard Mason type-III fracture of the radial head in a sawbone model. The outcome measurements were the quality of the reduction, and stability. A total of 96 fractures was created. Six surgeons were involved in the study and each reconstructed 16 fractures with 1.6 mm fine-threaded wires (Fragment Fixation System (FFS)), T-miniplates, 2 mm miniscrews and 2 mm Kirschner (K-) wires; four fractures being allocated to each method using a standard reconstruction procedure. The quality of the reduction was measured after definitive fixation. Biomechanical testing was performed using a transverse plane shear load in two directions to the implants (parallel and perpendicular) with respect to ultimate failure load and displacement at 50 N. A significantly better quality of reduction was achieved using the FFS wires (Tukey's post hoc tests, p < 0.001) than with the other devices with a mean step in the articular surface and the radial neck of 1.04 mm (SD 0.96) for the FFS, 4.25 mm (SD 1.29) for the miniplates, 2.21 mm (SD 1.06) for the miniscrews and 2.54 mm (SD 0.98) for the K-wires. The quality of reduction was similar for K-wires and miniscrews, but poor for miniplates. The ultimate failure load was similar for the FFS wires (parallel, 196.8 N (SD 46.8), perpendicular, 212.5 N (SD 25.6)), miniscrews (parallel, 211.8 N (SD 47.9), perpendicular, 208.0 N (SD 65.9)) and K-wires (parallel, 200.4 N (SD 54.5), perpendicular, 165.2 N (SD 37.9)), but significantly worse (Tukey's post hoc tests, p < 0.001) for the miniplates (parallel, 101.6 N (SD 43.1), perpendicular, 122.7 N (SD 40.7)). There was a significant difference in the displacement at 50 N for the miniplate (parallel, 4.8 mm (SD 2.8), perpendicular, 4.8 mm (SD 1.7)) vs FFS (parallel, 2.1 mm (SD 0.8), perpendicular, 1.9 mm (SD 0.7)), miniscrews (parallel, 1.8 mm (SD 0.5), perpendicular, 2.3 mm (SD 0.8)) and K-wires (parallel, 2.2 mm (SD 1.8), perpendicular, 2.4 mm (SD 0.7; Tukey's post hoc tests, p < 0.001)). The fixation of a standard Mason type-III fracture in a sawbone model using the FFS system provides a better quality of reduction than that when using conventional techniques. There was a significantly better stability using FFS implants, miniscrews and K-wires than when using miniplates.
AB - We have evaluated four different fixation techniques for the reconstruction of a standard Mason type-III fracture of the radial head in a sawbone model. The outcome measurements were the quality of the reduction, and stability. A total of 96 fractures was created. Six surgeons were involved in the study and each reconstructed 16 fractures with 1.6 mm fine-threaded wires (Fragment Fixation System (FFS)), T-miniplates, 2 mm miniscrews and 2 mm Kirschner (K-) wires; four fractures being allocated to each method using a standard reconstruction procedure. The quality of the reduction was measured after definitive fixation. Biomechanical testing was performed using a transverse plane shear load in two directions to the implants (parallel and perpendicular) with respect to ultimate failure load and displacement at 50 N. A significantly better quality of reduction was achieved using the FFS wires (Tukey's post hoc tests, p < 0.001) than with the other devices with a mean step in the articular surface and the radial neck of 1.04 mm (SD 0.96) for the FFS, 4.25 mm (SD 1.29) for the miniplates, 2.21 mm (SD 1.06) for the miniscrews and 2.54 mm (SD 0.98) for the K-wires. The quality of reduction was similar for K-wires and miniscrews, but poor for miniplates. The ultimate failure load was similar for the FFS wires (parallel, 196.8 N (SD 46.8), perpendicular, 212.5 N (SD 25.6)), miniscrews (parallel, 211.8 N (SD 47.9), perpendicular, 208.0 N (SD 65.9)) and K-wires (parallel, 200.4 N (SD 54.5), perpendicular, 165.2 N (SD 37.9)), but significantly worse (Tukey's post hoc tests, p < 0.001) for the miniplates (parallel, 101.6 N (SD 43.1), perpendicular, 122.7 N (SD 40.7)). There was a significant difference in the displacement at 50 N for the miniplate (parallel, 4.8 mm (SD 2.8), perpendicular, 4.8 mm (SD 1.7)) vs FFS (parallel, 2.1 mm (SD 0.8), perpendicular, 1.9 mm (SD 0.7)), miniscrews (parallel, 1.8 mm (SD 0.5), perpendicular, 2.3 mm (SD 0.8)) and K-wires (parallel, 2.2 mm (SD 1.8), perpendicular, 2.4 mm (SD 0.7; Tukey's post hoc tests, p < 0.001)). The fixation of a standard Mason type-III fracture in a sawbone model using the FFS system provides a better quality of reduction than that when using conventional techniques. There was a significantly better stability using FFS implants, miniscrews and K-wires than when using miniplates.
KW - Biomechanical Phenomena
KW - Bone Screws
KW - Female
KW - Fracture Fixation
KW - Humans
KW - Male
KW - Radius Fractures
KW - Evaluation Studies
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
U2 - 10.1302/0301-620X.89B11.19433
DO - 10.1302/0301-620X.89B11.19433
M3 - SCORING: Journal article
C2 - 17998199
VL - 89
SP - 1545
EP - 1550
IS - 11
ER -